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Healthcare Support

Prior Authorization Specialist CPhT

Career Insights for Medical Claims Processor / Representative

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Based on New Jersey data

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What they do

A Medical Claims Processor or Representative reviews and processes medical insurance claims and determines whether an insurance policy will cover a medical procedure. Gathers information from policy holders and organizes insurance files; may process checks with payments to policy holders when a medical claim is approved.

$49,093 / year median in New Jersey

-5% projected decline

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Job Description

Prior Authorization Specialist - CPhT - Montvale, NJ HealthCare Support is seeking a strategic, client-focused Prior Authorization Specialist to join a growing PBM organization. In this highly collaborative role, you'll communicate with providers to process prior authorizations and work with internal Account Managers to process claims overrides. Schedule Monday-Friday, 8:30 AM-5:00 PM Fully in office schedule Compensation $50,890 - $63,612 Benefits Medical, dental, and vision insurance Multiple medical plan options, including HSA-eligible plans Benefits effective the 1st of the month following hire 401(k) company match: 50% of the first 4% contributed 100% immediate vesting Paid Time Off Tuition reimbursement Short-term and long-term disability Basic Life & AD&D insurance at 2x salary FSA and HSA options
Daily Responsibilities :
Provide efficient administrative and operational support to adjudication, prior authorization, and clinical review teams. Accurately process claim overrides and case documentation in accordance with standard operating procedures (SOPs). Ensure compliance with all turnaround times and quality metrics to meet member and client expectations. Assist clinical pharmacists and operations teams with workflow management and reporting needs.
Required Qualifications:
An active state Pharmacy Technician license in the state of New Jersey Certified Pharmacy Technician (CPhT) required Claims adjudication, prior authorization expertise Strong customer service orientation and commitment to delivering concierge-level service Ability to work in a fast-paced environment Ready to take the next step? Click Apply Now for immediate consideration or email your resume or connect directly:
Email:
nicole.romero@healthcaresupport.com
Call:
(407) 848-1452
Schedule:
https://calendly.com/nrhcs Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.

Benefits

  • Paid Time Off (PTO)
  • Financial Aid/Assistance
  • 401(k) Plans
  • Health Insurance