Prior-Authorization/Scheduling Specialist - Pulmonary

Virtua; Marlton (NJ); On-site; USD 42,000 - 54,000; Full time

Job summary

Virtua in Marlton, New Jersey seeks a Medical Authorization Clerk to obtain prior authorizations for surgical procedures and verify patient benefits. You will upload documents, enter data into multiple databases, and monitor payer portals and phone communications.

The role requires previous medical clerical experience, familiarity with medical terminology, and strong data entry and phone skills. High school diploma or equivalent is required, with opportunities to resolve issues and support

Qualifications

• Previous medical clerical experience.
• Experience with prior authorizations strongly preferred.
• Understanding of medical terminology.
• Data entry proficiency.
• 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, enter data into multiple databases, and run reports as required.
• Alert facilitator of current or potential problems and assist in resolution.
• Appeal denied cases.
• Schedule peer to peers with Physician Providers.

Skills

Prior authorizations

Medical terminology

Data entry

Phone communication

Clerical experience

Clear communication

Education

High School diploma or equivalent

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.