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Assistant Prior Authorization Jobs in Rochester, NY

Highland Hospital

NP / Physician Assistant

Rochester, NY · On-site

$70/hr

... * Assist office nursing and secretarial staff in phone management and triage of patients. * In ... Complete clinical documentation, forms/paperwork requested by patients, prior authorization appeals ...

Schweigerderm

Medical Assistant (Full Time)

Brighton, NY · On-site

$16.50 - $21/hr

... prior authorization and procedures within established guidelines * Understand provider to patient flow and anticipate provider's next steps to the best of their ability * Prep rooms before and after ...

Schweigerderm

Medical Assistant (Full Time)

Brighton, NY

$16.50 - $21/hr

... prior authorization and procedures within established guidelines * Understand provider to patient flow and anticipate provider's next steps to the best of their ability * Prep rooms before and after ...

Schweigerderm

Medical Assistant (Per Diem)

Brighton, NY

$16.50 - $21/hr

... prior authorization and procedures within established guidelines * Understand provider to patient flow and anticipate provider's next steps to the best of their ability * Prep rooms before and after ...

Schweigerderm

Medical Assistant(Full time)

Rochester, NY

$18 - $22/hr

... prior authorization and procedures within established guidelines * Understand provider to patient flow and anticipate provider's next steps to the best of their ability * Prep rooms before and after ...

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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 are Assistant Prior Authorization jobs?

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, and why are they important?

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 are the most commonly searched types of Prior Authorization jobs in Rochester, NY? The most popular types of Prior Authorization jobs in Rochester, NY are:
What are popular job titles related to Assistant Prior Authorization jobs in Rochester, NY? For Assistant Prior Authorization jobs in Rochester, NY, the most frequently searched job titles are:
What job categories do people searching Assistant Prior Authorization jobs in Rochester, NY look for? The top searched job categories for Assistant Prior Authorization jobs in Rochester, NY are:
What cities near Rochester, NY are hiring for Assistant Prior Authorization jobs? Cities near Rochester, NY with the most Assistant Prior Authorization job openings:
Assistant Prior Authorization jobs near you
Medication Authorization Specialist

Medication Authorization Specialist

Rochester Regional Health

Rochester, NY • On-site

$18 - $25/hr

Part-time

Re-posted 12 days ago

Rochester Regional Health rating

7.4

Company rating: 7.4 out of 10

Based on 216 frontline employees who took The Breakroom Quiz

265th of 882 rated healthcare providers

Job description

  • Job Title: Medication Authorization Specialist
    Location: Rochester General MOB (1415 Portland Avenue, Rochester, NY 14621)
    Department: Pharmacy
    Hours Per Week: 20 Hours, Part-time
    Schedule: Monday, Tuesday and Thursday 8a-4p or 8:30a-5p
    Key Responsibilities:
    • Coordinate and submit medication prior authorization requests to insurance companies, ensuring timely approvals.
    • Monitor, track, and follow up on prior authorizations, step therapy requirements, and appeals processes.
    • Communicate with providers to obtain necessary clinical documentation for insurance submissions.
    • Assist patients in applying for pharmaceutical assistance foundation programs, grants, and/or co pay programs
    • Maintain up-to-date knowledge of manufacturer support programs and eligibility requirements.
    • Track patient enrollment status and renewal needs for financial programs.
    • Contact patients to explain coverage decisions, out-of-pocket costs, and available financial options.
    • Provide empathetic, patient-centered support to help navigate financial barriers to care.
    • Serve as a key point of contact for patients regarding their cardiology medication access issues.
    • Document all activities accurately and timely in the Electronic Health Records (EHR)
    • Work collaboratively with physicians, nurses, pharmacists, and administrative staff to streamline access workflows.
    • Participate in process improvement initiatives to enhance patient experience and medication access efficiency.
    • All other duties as assigned.

    Preferred Qualifications:
    • Associates Degree in healthcare administration or business preferred.
    • Experience with prior authorizations, pharmacy or specialty medications preferred.
    • Proficiency in electronic medical records (EMR) systems and Microsoft Office applications.
    • Excellent communication skills including both oral and written as well as interpersonal skills.
    • Ability to handle simultaneous tasks paying great attention to detail.
    • Flexibility and ability to work as a team player.
    • Understanding of managed care, formularies, and payer policies.
    • Experience with Electronic Health Records (EHR) systems.
    • Strong verbal and written skills for interacting with providers, patients, and insurers.
    • Ability to pay attention to detail and ability to manage high volumes of requests with accuracy.

    Minimum Qualifications:
    • 2 years work experience in a healthcare settings, medical billing, pharmacy, or insurance verification.

    Required Licensure/Certification:
    • N/A

EDUCATION:
LICENSES / CERTIFICATIONS:
PHYSICAL REQUIREMENTS:
M - Medium Work - Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects; Requires frequent walking, standing or squatting.
For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements.
Any physical requirements reported by a prospective employee and/or employee's physician or delegate will be considered for accommodations.
PAY RANGE:
$18.00 - $25.00
CITY:
Rochester
POSTAL CODE:
14621
The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.
Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.

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