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Prior Authorization Coordinator Jobs in Basking Ridge, NJ

3Y

Prior Authorization Lead

New York, NY · On-site

$100K - $140K/yr

About the Role We are seeking a Prior Authorizations Lead to design, manage, and scale 3Y Health ... care coordination. * Develop and track KPIs to monitor authorization performance, identify ...

Astera

Patient Access Coordinator

East Brunswick, NJ · On-site

$22 - $28/hr

Coordinate with prior authorization teams, healthcare providers, patients, and pharmacy staff to facilitate timely prescription processing. * Track and follow up on outstanding prior authorizations ...

Astera

Patient Access Coordinator

East Brunswick, NJ · On-site +1

$22/hr

Coordinate with prior authorization teams, healthcare providers, patients, and pharmacy staff to facilitate timely prescription processing. * Track and follow up on outstanding prior authorizations ...

Highmark Health

Pharmacy Coordinator

New York, NY · On-site

... and coordination of benefits practices/procedures. ESSENTIAL RESPONSIBILITIES * Communicate ... Review of prior authorization criteria for drug products. * Recommend staffing adjustments ...

Highmark Health

Pharmacy Coordinator

New York, NY · On-site

... and coordination of benefits practices/procedures. ESSENTIAL RESPONSIBILITIES * Communicate ... Review of prior authorization criteria for drug products. * Recommend staffing adjustments ...

mycenters

UM Care Coordinator

Staten Island, NY

$19.50 - $26.50/hr

Assists in the prior authorization of services and ongoing authorization requests * Assists in completing authorization updates as needed based on the care plan of the member * Coordinates with ...

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Prior Authorization Coordinator information

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How much do prior authorization coordinator jobs pay per hour?

As of Jul 30, 2026, the average hourly pay for prior authorization coordinator in Basking Ridge, NJ is $21.97, according to ZipRecruiter salary data. Most workers in this role earn between $18.32 and $22.79 per hour, depending on experience, location, and employer.

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

AspectPrior Authorization CoordinatorMedical Billing Specialist
CredentialsTypically requires knowledge of insurance policies, healthcare regulations, and sometimes certifications like CPC or CPC-HRequires coding certifications (CPC, CCS) and knowledge of billing procedures
Work EnvironmentHealthcare facilities, insurance companies, or billing companiesMedical offices, hospitals, or billing companies
Employer & Industry UsageUsed in healthcare settings to manage insurance approvalsUsed across healthcare to process and submit claims
Search & Comparison IntentPeople compare roles related to insurance approval processesPeople compare roles related to billing and claims processing

The Prior Authorization Coordinator focuses on obtaining insurance approvals before treatment, ensuring coverage compliance. In contrast, the Medical Billing Specialist handles submitting claims and processing payments after services are rendered. Both roles are essential in healthcare administration but differ in their primary functions and workflows.

What are the key skills and qualifications needed to thrive as a Prior Authorization Coordinator, and why are they important?

To thrive as a Prior Authorization Coordinator, you need strong knowledge of medical terminology, insurance processes, and healthcare regulations, often supported by experience in medical billing or a related certification. Familiarity with electronic health records (EHR), insurance portals, and prior authorization management systems is typically required. Attention to detail, organizational skills, and effective communication are essential soft skills for efficiently handling authorization requests and collaborating with providers and insurers. These skills ensure timely approvals, minimize claim denials, and support smooth patient access to prescribed care.

What are Prior Authorization Coordinators?

Prior Authorization Coordinators are healthcare professionals responsible for managing and obtaining approval from insurance companies before certain medical services, procedures, or medications are provided to patients. Their main duties include reviewing patient information, communicating with healthcare providers and insurers, and ensuring all necessary documentation is submitted for timely authorization. They play a crucial role in reducing delays in care and helping patients navigate complex insurance requirements. Strong communication, attention to detail, and knowledge of insurance processes are essential skills for this role.

What are some common challenges faced by Prior Authorization Coordinators, and how can they be managed effectively?

Prior Authorization Coordinators often encounter challenges such as navigating complex insurance requirements, keeping up with frequent policy changes, and managing high volumes of requests. To handle these effectively, coordinators need strong organizational skills, attention to detail, and the ability to communicate clearly with both healthcare providers and insurance representatives. Staying updated on payer guidelines and using electronic health record (EHR) systems efficiently can also streamline the process and reduce delays in patient care.
What job categories do people searching Prior Authorization Coordinator jobs in Basking Ridge, NJ look for? The top searched job categories for Prior Authorization Coordinator jobs in Basking Ridge, NJ are:
What cities near Basking Ridge, NJ are hiring for Prior Authorization Coordinator jobs? Cities near Basking Ridge, NJ with the most Prior Authorization Coordinator job openings:
Prior Authorization Coordinator jobs near you
Infographic showing various Prior Authorization Coordinator job openings in Basking Ridge, NJ as of July 2026, with employment types broken down into 1% As Needed, 87% Full Time, 11% Part Time, and 1% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $45,693 per year, or $22 per hour.

Prior Authorization Specialist

LTC PHARMA HLDG LLC

Rockaway, NJ • On-site

$23 - $25/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 5 days ago

Job description

WHO WE ARE
At Polaris Pharmacy Services, we're more than a pharmacy - we're a dedicated partner in care, transforming how patients experience long-term, post-acute, correctional, PACE, and specialty pharmacy services. As industry leaders, we're raising the bar for quality and coordination across all sites of care, ensuring every patient receives seamless, compassionate, and expert support.
Founded in 2015, Polaris is proud to be locally and independently owned, with a growing national footprint. Our team thrives in a mission-driven environment where innovation meets purpose, and every role contributes to making a real impact. We offer more than just a job - we provide competitive pay, robust benefits, and genuine opportunities for career advancement.
If you're passionate about shaping the future of pharmacy and making a difference in the lives of those who need it most, we invite you to grow with us.
JOB SUMMARY:
The Prior Authorization Specialist is responsible for managing and identifying a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks to Polaris and their customers. The Prior Authorization Specialist must be responsive and courteous when addressing our customers' needs. Successful Specialists are dedicated to meeting the expectations and requirements of the position; understanding customer information and using it to improve products and services we deliver; talking and acting with customers in mind; establishing and maintaining effective relationships with co-workers and customers, thus gaining our customers' trust and respect.
DUTIES/RESPONSIBILITIES:
  • Manage and identify a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks to Polaris and their customers
  • Research, analyze and appropriately resolve rejected claims by working with national Medicare D plans, third party insurance companies, and all state Medicaid plans to ensure maximum payer reimbursement adhering to critical deadlines
  • Ensure approval of claims by performing appropriate edits and/or reversals to ensure maximum payer reimbursement
  • Contact providers and/or facility contacts as necessary to obtain additional information
  • Monitor and resolve revenue at risk associated with payer set up, billing, rebilling, and reversal processes
  • Work as a team to identify, document, communicate, and resolve payer/billing trends and issues
  • Complete, communicate, and submit prior authorizations forms in a timely manner
  • Support training needs
  • Prepare and maintain reports and records for processing
  • Perform other tasks as assigned.
  • Follow all applicable government regulations, including HIPAA
  • Comply with departmental policies regarding safety, attendance, and dress code
  • Overtime, holidays, and weekends may be required and/or expected
  • Conduct job responsibilities in accordance with the standards set out in the Company's Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards
  • Other duties as assigned; Job duties may vary depending on business needs

QUALIFICATIONS/COMPETENCIES:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
REQUIRED SKILLS/ABILITIES:
  • Able to read, write, speak, and understand the English language
  • Able to retain a large amount of information and apply that knowledge to related situations
  • Able to work in a fast-paced environment
  • Basic computer knowledge skills required
  • Basic math and analytical skills
  • Experience with alpha-numeric data entry
  • Proficient in Microsoft Word, Excel, and Outlook required
  • Customer Service
  • Results-oriented
  • Good organization/Attention to detail
  • Reliable
  • Problem solver
  • Able to work various shifts and days
  • Adaptability to an ever-changing environment

EDUCATION and/or EXPERIENCE:
  • High School diploma or equivalent required
  • Minimum of one (1) or more years working as a pharmacy technician in a retail environment preferred (long-term care pharmacy preferred)
  • Framework LTC & General computer knowledge & 10-key Number Entry preferred

PHYSICAL DEMANDS
The physical demands described here are representative of those that should be met by an employee to successfully perform the essential functions of this job:
  • May sit or stand seven (7) to ten (10) hours per day
  • The employee is occasionally required to sit; climb or balance; and stoop, kneel, bend, walk
  • May be necessary to work extended hours as needed
  • May lift and/or move up to 30 pounds
  • The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this role

HOLIDAY & PTO POLICY
  • Paid holidays are provided annually, with 6 days offered each year, along with 5 sick days.
  • Employees earn up to 10 PTO days each year, with rollover options and milestone bonuses.
  • Employees have the option to cash out up to 10 PTO hours each quarter for added financial flexibility.

Please note, because we are a pharmacy most of our locations are open 24-hours a day, 7 days a week and therefore schedules may change as determined by the needs of the business.
BENEFITS for full time Employees
  • Medical, Dental, and Vision insurance
  • 401 (k) (available for Part Time & Full Time EEs)
  • Company Paid Life insurance
  • Short-term and Long-term disability insurance
  • Tuition reimbursement
  • Personal Time Off (PTO)
  • Competitive pay with annual performance reviews and merit-based raises
  • Career growth potential
  • Annual on-site voluntary Flu Vaccines
  • Employee referral bonus program

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