• *JOB DESCRIPTION Busy specialty practice (Sleep Medicine & Pulmonary) at Paoli Hospital, is seeking an experienced full time remote Prior Authorization Specialist and New Patient Scheduler, to support the providers and staff at our growing practice. Applicant must live local-no out of state applicants please. Experience with medication and procedure authorizations is required, as well as new patient intake & scheduling experience. Knowledge of EMR, use of prescription drug monitoring portal and covermymeds.com is required.

• *OVERVIEW We are seeking a dedicated and detail-oriented REMOTE PRIOR AUTHORIZATION SPECIALIST AND NEW PATIENT SCHEDULER to join our healthcare team. The ideal candidate will possess a strong background in medical office operations, insurance verification, and prior authorization processes, with excellent organizational and communication skills. This role involves managing insurance authorizations efficiently while coordinating new patient appointments to ensure seamless patient care delivery. The position offers the opportunity to work remotely within a dynamic healthcare environment committed to providing exceptional service and patient support. Review and process prior authorization requests for medications (including biologics) and services/testing. Candidates will also help streamline the new patient intake and scheduling process for the Paoli office.
• *DUTIES
• Obtain prior authorizations from managed care organizations and insurance providers for various medical procedures and treatments, ensuring timely approvals.
• Verify insurance coverage and benefits for new patients by reviewing policies, including HIPAA compliance, to facilitate smooth scheduling and billing processes.
• Schedule new patient appointments accurately, coordinating with providers and patients to accommodate availability and specific needs.
• Maintain detailed medical records, ensuring all documentation aligns with HIPAA regulations and coding standards such as CPT, ICD-10, and ICD coding.
• Communicate effectively with insurance companies, healthcare providers, and patients to resolve authorization issues or discrepancies promptly.
• Utilize medical terminology and office experience to navigate electronic health records systems efficiently.
• Support the medical office team by managing appointment calendars, confirming patient visits, and updating records as necessary.
• Ensure compliance with all relevant managed care policies, HIPAA regulations, and medical coding standards while maintaining confidentiality at all times.
• *Experience
• Prior experience in a medical office setting/environment is highly preferred.
• Proven knowledge of managed care processes, insurance verification, and prior authorization procedures.
• Familiarity with medical terminology, medical records management, and medical coding practices including CPT, ICD-10, and ICD coding systems.
• Experience working remotely in a healthcare or administrative role is advantageous.
• Strong understanding of HIPAA regulations to safeguard patient information effectively.
• Office experience combined with excellent organizational skills to handle multiple tasks efficiently in a fast-paced environment.
• Join our team to play a vital role in streamlining patient access to care while supporting our healthcare providers through expert authorization management and scheduling! Pay $19.00 - $21.00 per hour Benefits
• 401(k)
• Dental insurance
• Free parking
• Health insurance
• Health savings account
• Paid sick time
• Paid time off
• Work from home Work Location Remote Apply To this Job