Englewood Health, is a leading healthcare system comprising Englewood Hospital and the Englewood Health Physician Network, is committed to delivering exceptional patient care across northern New Jersey. We are dedicated to fostering a supportive and inclusive work environment where every team member can bring their skills, creative ideas, positive approaches, and transforming the lives of patients and the communities we serve.
Job Summary:
Under general supervision, the Pre-Authorization Representative serves as a liaison between physicians, patients, and insurance carriers to secure timely authorizations and pre-certifications for medical tests, procedures, and therapies. This role contacts insurance companies on behalf of Medical Center physicians to obtain required approvals, gathers and verifies patient demographic and clinical information from physician offices, and ensures all documentation meets payer requirements. The representative performs accurate data entry, maintains authorization records, tracks certification status, and supports compliance with insurance guidelines to facilitate efficient patient care and reimbursement.
Department: Patient Access Services
Location: Englewood, NJ
Status: Full-time
Shift: 8 hour Evenings
Hours: Monday -Thursday 11:30a-7:30p; Sunday, 7:00a-3:00p
Job Essentials:
- Excellent interpersonal and communications skills
- Ability to function independently
- Clerical, data entry and some typing skills, including: Filing and record keeping
- Ability to work in fast fast-paced environment
- Flexible and able to pay close attention to details
- Ability to complete needed tasks with speed accuracy
- Knowledge of CPT, ICD, HCPCS and/or drug codes
Education Requirements:
- HS Diploma or GED education or minimum 5 years’ experience in related field (if HS or GED prepared, a minimum of one year of experience is required)
- One or more years of related insurance experience in a healthcare facility or physician's office preferred
