Pre-Authorization Specialist

Pre-Authorization Specialist

📍Passaic County, NJ

A gastroenterology practice is looking for a Pre-Authorization Specialist to join their growing team. This role is ideal for someone with strong insurance authorization experience, particularly within GI or infusion/biologics, who thrives in a fast-paced environment.

What You'll Do

• Obtain pre-authorizations for GI procedures (colonoscopy, endoscopy, ERCP, capsule endoscopy, etc.), requiring a working knowledge of CPT and ICD codes
• Secure pre-authorizations for infusion therapies, including biologic medications - prior exposure to biologics is a plus
• Maintain a two-week-ahead authorization timeline to account for potential insurance delays
• Verify patient eligibility daily using multiple portals (ECW, Navinet, Availity, E-tactics, etc.)
• Communicate with insurance carriers when given inaccurate or incomplete information, advocating effectively on behalf of patients
• Explain patient financial responsibility (deductibles, coinsurance, copays) directly to patients via phone prior to their procedures
• Communicate professionally and clearly with providers, staff, and patients via phone and email

What You Bring

• Comprehensive knowledge of insurance carrier policies, procedures, and pre-authorization workflows
• Comfort and working knowledge of biologic medications - candidates with no prior authorization experience will not be considered, as there isn't bandwidth to train from scratch
• Strong attention to detail and the ability to work quickly without sacrificing accuracy
• Excellent verbal and written communication skills, with a professional, patient-facing demeanor
• Ability to multitask in a high-volume environment

Schedule & Benefits

• Hybrid schedule: 2 days/week in-office (Mon/Wed or Tue/Thu), plus one Friday per month for full team meetings
• 2 weeks vacation, 1 week sick/personal time
• Compensation: $25/hr based on experience

If you have hands-on pre-authorization experience, ideally with infusion/biologic medications, and want to be part of a busy, dynamic GI practice, we'd love to hear from you.