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Assistant Prior Authorization Jobs in Fishkill, NY

Rezolut

Registration Administrator

New Windsor, NY · On-site

$18 - $21/hr

Answer multi-line phones and assist patients and referring offices. * Monitor voicemail, email, fax ... and prior authorization workflows is preferred. Qualifications * High school diploma or GED ...

Rezolut

Registration Administrator

New Windsor, NY · On-site

$18 - $24.75/hr

Collect co-pays and obtain required patient forms. • Answer multi-line phones and assist patients ... prior authorization workflows is preferred. • High school diploma or GED required. • One or ...

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Assistant Prior Authorization information

What are some common challenges faced by an assistant prior authorization, and how can they be effectively managed?

Assistant Prior Authorization professionals often encounter challenges such as navigating complex insurance requirements, managing high volumes of requests, and ensuring timely communication between healthcare providers, patients, and insurance companies. Staying organized and maintaining up-to-date knowledge of payer policies are essential for success. Using electronic health records efficiently and fostering strong teamwork with clinical staff can help streamline the approval process and reduce delays, ultimately improving patient care.

What is an assistant prior authorization?

Assistant Prior Authorization jobs involve supporting healthcare providers and insurance companies by helping to obtain approval for specific medical procedures, treatments, or medications. These assistants review patient information, coordinate with physicians and insurance representatives, and ensure all necessary documentation is submitted for approval. The role is crucial in helping patients receive timely care by navigating insurance requirements and reducing delays. Strong organizational and communication skills are essential in this position.

What is the difference between Assistant Prior Authorization vs Medical Billing Specialist?

AspectAssistant Prior AuthorizationMedical Billing Specialist
Required CredentialsHigh school diploma, certification in healthcare administration or relatedHigh school diploma, certification in medical billing or coding
Work EnvironmentHealthcare offices, insurance companies, hospitalsMedical offices, billing companies, healthcare facilities
Primary ResponsibilitiesObtaining prior approvals from insurance for procedures/servicesProcessing and submitting medical claims, coding, and billing
Industry UsageCommonly used in healthcare and insurance sectorsWidely used in healthcare billing and revenue cycle management

While both roles operate within the healthcare industry, an Assistant Prior Authorization focuses on securing insurance approvals before procedures, whereas a Medical Billing Specialist handles claims processing and billing after services are rendered. Understanding these differences helps clarify career paths and employer expectations in healthcare administration.

What are the key skills and qualifications needed to thrive as an assistant prior authorization?

To thrive as an Assistant Prior Authorization, you generally need a strong understanding of medical terminology, health insurance processes, and prior authorization requirements, often supported by a high school diploma or medical office training. Familiarity with electronic health record (EHR) systems, payer portals, and prior authorization software is typically required. Attention to detail, strong organizational skills, and effective communication are standout soft skills in this position. These skills ensure accurate and timely processing of authorizations, minimize insurance denials, and support efficient patient care coordination.
What cities near Fishkill, NY are hiring for Assistant Prior Authorization jobs? Cities near Fishkill, NY with the most Assistant Prior Authorization job openings:
Assistant Prior Authorization jobs near you

Prior Authorization Specialist

Cornerstone Family Healthcare

Middletown, NY • On-site

$21/hr

Full-time

Medical, Retirement, PTO

Posted 27 days ago

Job description

Job Type
Full-time
Description
Cornerstone Family Healthcare is actively recruiting for a Prior Authorization Specialist to join our growing team in Middletown, NY.
RATE OF PAY/SALARY: $21.00 per hour
WORK LOCATION(S): Middletown, NY
STATUS: Full-time
CORNERSTONE'S MISSION:
Cornerstone Family Healthcare is a non-profit Federally Qualified Health Center with a mission to provide high quality, comprehensive, primary and preventative health care services in an environment of caring, dignity and respect to all people regardless of their ability to pay. For more than fifty years, Cornerstone has been responsive to meeting the needs of the communities in which we serve with a continued emphasis on the underserved and those without access to health care regardless of race, economic status, age, sex, sexual orientation or disability.
CORNERSTONE BENEFITS:
Competitive salaries I Health Benefits I Retirement plan I Paid Time Off I Sick Time I Flexible Spending I Dependent Care I Paid Holidays
Job Duties:
  • Assists patients in obtaining prior authorizations for treatment requiring insurance pre-authorization.
  • Handles all prior authorization submissions to proper insurances.
  • Documents in EMR authorization status, actions, and outcomes.
  • Communicates well with internal providers to obtain all the required information to submit prior authorization efficiently.
  • Has medical terminology knowledge, i.e. ICD, CPT, Procedure Codes/Names, & Test Names.
  • Responsible for notifying the appropriate internal departments of any information that they need to be aware of, including complaints or adverse event notifications.
  • Communicates and builds relationships with insurance carriers and servicing providers or facilities.
  • Schedule peer to peer meeting between CFH provider and insurance company for prior authorization denials.
  • Request and prepare supporting documentation for the medical necessity for the service being authorized, examples include medical records, labs, previous prior authorization(s), appeals, denials and prescriptions.
  • Sorts daily work queues and is accountable to identify and process the daily work.
  • Preforms initial insurance benefit verification and pre-surgical authorization for new OB/GYN or Podiatry surgical cases.
  • Advises Provider and patients of any changes or cancellations of surgical/procedure bookings.
  • Fields phone calls from staff and service providers and resolves inquiries related to prior authorizations.
  • Easily manages multiple authorization requests at once.
  • Exemplifies excellent customer service with patients, visitors, and other employees; shows courtesy, friendliness, helpfulness, and respect.
  • Consistently demonstrates respect for the capabilities, different cultures and/or personalities of internal and external customers.
  • Maintains and ensures patient privacy and confidentiality.
  • Takes the initiative to proactively assist others.
  • Maintains open and effective communication with providers and employees to ensure quality.
  • Perform other related duties as assigned

Requirements
  • Bilingual (English & Spanish)
  • At least one-year clerical experience in a health-related field
  • Knowledge of data entry
  • Pleasant telephone manner

Salary Description
21.00 hourly

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