Prior-Authorization/Scheduling Specialist - Pulmonary

Virtua Health; Marlton (NJ); On-site; USD 25,000 - 37,000; Full time

Benefits offered by this job

Medical insurance

Dental and vision insurance

Flexible spending accounts

403(b) plan

Paid time off

Paid sick leave

Disability insurance

Life insurance

Tuition assistance

Employee assistance program

Job summary

Virtua Health in Marlton, NJ seeks a Detail-oriented Medical Authorization Clerk to obtain prior authorizations for surgical procedures and verify patient benefits. The role requires data entry, navigating payer portals, and documenting activities to support timely approvals.

Responsibilities include appealing denials, scheduling peer-to-peer discussions with physicians, and uploading clinical documents while maintaining clear communication with patients and providers.

Qualifications

• Previous medical clerical experience.
• Experience with prior authorizations strongly preferred.
• Understanding of medical terminology.
• Computer user proficiency (data entry).
• Clear communication skills.
• Professional phone demeanor.

Responsibilities

• Obtain prior authorizations of surgical procedures.
• Verify benefits and eligibility on payer portals and via telephone.
• Upload clinical documents, enters data into multiple data bases, and runs reports as required.
• Alert facilitator of current or potential problems and assists in resolution.
• Appeal denied cases.
• Schedule peer to peers with Physician Providers.

Skills

Medical clerical

Prior authorizations

Medical terminology

Data entry

Communication skills

Phone etiquette

Education

High School Diploma

Job description

Summary

This position is responsible for obtaining prior authorizations for surgical procedures and ensuring accurate verification of patient benefits and eligibility.

Position Responsibilities

• Obtain prior authorizations of surgical procedures.
• Verify benefits and eligibility on payer portals and via telephone.
• Upload clinical documents, enters data into multiple data bases, and runs reports as required.
• Alert facilitator of current or potential problems and assists in resolution.
• Appeal denied cases.
• Schedule peer to peers with Physician Providers.

Position Qualifications Required / Experience Required

• Previous medical clerical experience.
• Experience with prior authorizations strongly preferred.
• Understanding of medical terminology.
• Computer user proficiency (data entry).
• Clear communication skills.
• Professional phone demeanor.

Required Education

High School Diploma or equivalent required.

Salary

$18.89 - $27.81 Hourly

Benefits

Virtua offers a comprehensive package of benefits for full-time and part-time colleagues, including, but not limited to:

• medical/prescription, dental and vision insurance
• health and dependent care flexible spending accounts
• 403(b) (401(k) subject to collective bargaining agreement)
• paid time off
• paid sick leave as provided under state and local paid sick leave laws
• short-term disability and optional long-term disability
• colleague and dependent life insurance and supplemental life and AD&D insurance
• tuition assistance
• an employee assistance program that includes free counseling sessions

Eligibility for benefits is governed by the applicable plan documents and policies.