Prior Authorization Specialist — Care Continuum (Tuition Reimbursement)

Bergen New Bridge Medical Center; Paramus (NJ); Presencial; USD 45.000 - 58.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Tuition reimbursement

9 paid holidays

Generous vacation & sick leave

Descripción de la vacante

Bergen New Bridge Medical Center is seeking a qualified Prior Authorization Specialist for our Continuum of Care team in Paramus, NJ. This full-time day-shift role supports clinical staff by processing authorizations and communicating with insurers to secure patient access to medications and services.

Responsibilities include obtaining authorizations via CoverMyMeds and payer portals, gathering documentation, and appealing denials when necessary.

Formación

• 2+ years of experience with prior authorizations or insurance verification preferred.
• Familiarity with EPIC is preferred but not required.
• Knowledge of Medicare/Medicaid and commercial authorization processes is a plus.

Responsabilidades

• Complete prior authorizations through CoverMyMeds and payer portals.
• Communicate with insurance companies to clarify coverage requirements.
• Collaborate with providers to gather clinical documentation for medical necessity.
• Inform patients about authorization updates and required documentation.
• Track and document authorization statuses for timely access to care.
• Assist providers and nurses with authorization questions.
• Review denials and submit supporting notes for appeals.
• Maintain HIPAA compliance and clinic policies.
• Other department-related duties as assigned.

Conocimientos

Prior authorizations

Insurance verification

Medical terminology

Communication

Educación

High School Diploma/ GED

Herramientas

EPIC

Availity

Navinet

Descripción del empleo

Bergen New Bridge Medical Center is seeking a qualified Prior Authorization Specialist for our Continuum of Care team in Paramus, NJ. This full-time day-shift role supports clinical staff by processing authorizations and communicating with insurers to secure patient access to medications and services.

Responsibilities include obtaining authorizations via CoverMyMeds and payer portals, gathering documentation, and appealing denials when necessary.