Jefferson Health
Authorization Representative
Montgomery County, PA · Full-time · Posted Jun 8, 2026
- Experience
- 1 year required.
- Education
- High School Diploma/GED.
About the job
Coordinates insurance benefit verification and obtains prior authorizations and referrals for patient services, supporting accurate claims and timely reimbursement.
What you'll do
- Coordinates with providers and insurers to obtain authorizations and verify coverage, benefits, and precertification.
- Reviews medical necessity and clinical information to confirm payer requirements are met.
- Monitors work queues and schedules, communicates authorization exceptions, and estimates patient financial responsibility.
What they ask for
- High School Diploma/GED.
- 1 year experience in healthcare insurance verification, prior authorization requirements, and insurance benefits structures.
- Experience with multiple insurance payers and understanding medical necessity requirements.
- Prior experience with electronic health record (EHR) systems and insurance portals; familiarity with clinical documentation, CPT, ICD-10, HCPS coding, and patient rights laws.
Nice to have
- Associate’s Degree in health administration, healthcare management or related field.
Tools
electronic health record (EHR) systems, insurance portals, CPT, ICD-10, HCPS
Model-written summary · the original posting is authoritative