Prior Authorization Specialist – Clinic (Efficient Approvals)

Dent Neurologic Group LLP; Town of Amherst (NY); On-site; USD 34,000 - 39,000; Full time

Benefits offered by this job

Medical, Dental & Vision Plans

Life Insurance

401(k) Retirement Plan

Paid Time Off

Paid Holidays

Free Onsite Parking

Wellness Program

Learning & Development Opportunities

No overnight shifts

Job summary

Dent Neurologic Institute in Amherst, NY is seeking a full-time entry-level specialist to ensure prior authorizations are complete, accurate and current so patients receive medications without delay.

Responsibilities include submitting authorizations for prescriptions, reviewing documents for accuracy, and coordinating with nursing staff for remote days, while maintaining quality and meeting payer requirements. Strong attention to detail and communication are essential.

Qualifications

• Preferred healthcare experience; not mandatory.
• Word, Excel and EMR experience; eCW preferred.
• Strong attention to detail and problem solving.
• Good communication skills and ability to work with a team to accomplish goals.
• Self-directed, self-motivated to accomplish work.

Responsibilities

• Submit authorizations for prescription medications ordered in the employed department for all medical insurances and no-fault (if applicable).
• Review documents (D) jelly bean multiple times throughout shift to perform prior auth submission through appropriate website (i.e. Cover My Meds).
• If there is a day(s) working remote, communicate and send any prior auth requests to a nursing team member in the office to print, perform and submit via electronic fax.
• Perform training for operational teams to ensure quality goals are met.
• Communicate to payers if there is issue with prior authorization and resolve effectively and efficiently.
• Follow payor formulary guidance to submit information to insurance companies to gain approval of patient’s medication.
• Other duties as assigned and requested

Skills

Word

Excel

EMR experience

Attention to detail

Communication skills

Team player

Self-motivated

Education

High School Diploma

Tools

EMR system (eCW)

Job description

Dent Neurologic Institute in Amherst, NY is seeking a full-time entry-level specialist to ensure prior authorizations are complete, accurate and current so patients receive medications without delay.

Responsibilities include submitting authorizations for prescriptions, reviewing documents for accuracy, and coordinating with nursing staff for remote days, while maintaining quality and meeting payer requirements. Strong attention to detail and communication are essential.