Pre-Authorization Specialist

Remote Full-time
About the position

SportsMed Physical Therapy is seeking a Pre-Authorization Specialist. This position will start on-site in Glen Rock NJ and will transition to a hybrid-remote role after 1-2 months of on-site training.

We are one of New Jersey’s leading providers of physical rehabilitation services. With multiple locations throughout the state, we can offer you a fast paced and challenging career opportunity. If you are passionate about healthcare, motivated and want to make a difference, SportsMed is the place for you.

The Pre-Authorization Specialist is responsible for identifying prior authorization requirements by insurance/payer and processes and completes the authorizations for scheduled visits. Ensures patient demographic, insurance information and verification has been established and documented. Documents all pending, approved and denied pre-authorizations within an EMR (WebPT) system. Communicates effectively with billers and front desk staff if services are approved or denied to reduce denials and facilities peer to peer review when needed.

Responsibilities
• identifying prior authorization requirements by insurance/payer
• processes and completes the authorizations for scheduled visits
• Ensures patient demographic, insurance information and verification has been established and documented
• Documents all pending, approved and denied pre-authorizations within an EMR (WebPT) system
• Communicates effectively with billers and front desk staff if services are approved or denied to reduce denials and facilities peer to peer review when needed.

Requirements
• Minimum 2 years experience in pre-authorization and insurance verification
• Strong verbal and written communication skills
• Adept to learning and using multiple software programs
• Demonstrated ability to organize and prioritize work
• Strong attention to detail and follow up with minimal direction and supervision
• Ability to work and collaborate with front desk and billing personnel
• Ability to handle large volume of pre-auths and multi-task concurrently
• Ability to navigate multiple payer websites
• Able to work independently and apply critical thinking skills for various payers
• Knowledge of Excel Spreadsheets

Nice-to-haves
• Experience with PIP and Workers compensation preferred

Benefits
• Excellent career growth opportunity
• Competitive pay based on experience
• Medical benefits, life and disability insurance, 401k match, PTO, sick time, paid holidays

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