Scheduling Specialist/Prior Authorization - Orthopedics

Virtua Health; Moorestown Township (NJ); On-site; USD 40,000 - 55,000; Full time

Job summary

A healthcare organization is seeking a dedicated individual to handle prior authorizations for surgical procedures. The role involves verifying patient benefits, entering data, and assisting with appeals for denied cases. Ideal candidates will have medical clerical experience and proficiency in computer data entry. A High School Diploma or equivalent is required, alongside strong communication skills and a professional demeanor on the phone. This is a full-time position based in Moorestown Township, New Jersey.

Responsibilities

• Obtain prior authorizations for 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-peer with Physician Providers.

Skills

Medical clerical experience

Prior authorizations

Understanding of medical terminology

Computer proficiency (data entry)

Clear communication skills

Professional phone demeanor

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 databases, and runs reports as required.
• Alert facilitator of current or potential problems and assists in resolution.
• Appeal denied cases.
• Schedule peer-to-peer 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.