We are seeking a skilled Medical Prior Authorization Specialist to join our team. The ideal candidate will be responsible for obtaining prior authorizations for medications, medical procedures, diagnostic studies and DME's. This role involves coordination with various departments, reaching out to insurance providers, gathering, and providing necessary documentation, scheduling peer-to-peer reviews, and meticulously documenting the entire authorization process. When working in CMA role, is responsible for providing general direct and indirect patient care in a clinical setting under the direct supervision of a physician. Collaborates with the interdisciplinary care team to ensure functionality of practice operations to provide excellent patient care. Ensures medical facilities run smoothly, and works in a clerical, administrative, or clinical capacity, and may even be asked to perform more specialized tasks. Position Principal Accountabilities: 1. Initiate and manage the prior authorization process to include medications, diagnostic testing, medical procedures, and DME's. 2. Communicate effectively with internal departments and insurance companies to obtain necessary authorization 3. Gather and organize patient medical records, treatment plans, and other relevant documentation required for authorization. 4. Ensure all documentation provided meets insurance company requirements and guidelines. 5. Collaborate with providers to obtain additional information or clarification as needed. 6. Schedule and facilitate peer-to-peer reviews between providers and insurance company medical directors. 7. Document all communication and actions taken throughout the authorization process accurately and thoroughly. 8. Monitor the progress of authorization requests and follow up as necessary to expedite approvals. 9. Stay updated on changes in insurance policies, guidelines, and procedures related to prior authorizations. 10. Provide support and guidance to providers and staff regarding prior authorization requirements and processes. 11. Work in a CMA role with patients as needed for additional coverage. 12. Provide any additional support for projects required within the departments. 13.. Handles patient intake, updates medical records, and administers appropriate screening tools. 14. Records medical information and test results, conducts patient interviews, takes and records vital signs, collects specimens, and administers medication under physician supervision. 15. Assists with walk-in and scheduled clinic visits, ensures verification and recording of clinical data and adherence to quality standards. 16. Monitors environment for compliance with continual accreditation readiness and evaluates practice schedule for changes or updates. 17. Demonstrates knowledge of the certified medical assistant scope of practice, incorporating elements of holistic patient-centered and team-based care. 18. Guides patients through the health care system and helps patients arrive at scheduled appointments on time. 19. Provides emotional support related to the patient's clinical situation in accordance with the patient's plan of care. 20. Performs other related duties as assigned. Required: + High School Diploma or equivalent. + **National Certification CCMA from: NHA, AAMA, NAHP, ARMA, AMT, AMCA, or NCCT. + OR Precertification agreement must be signed if expired or receiving certification within 60 days of employment.** Preferred: 1. Associate's degree in Medical Care or related field. 2. Min 1 year of experience in Health Care services. 3. Strong understanding of medical terminology, procedures, and pharmaceuticals. 4. Excellent communication skills, both verbal and written, with the ability to effectively interact with insurance companies, healthcare providers, and patients. 5. Detail-oriented and organized, with the ability to manage multiple tasks and prioritize workload effectively. 6. Proficient computer skills, including experience with electronic medical records Epic systems and Microsoft Office Suite. 7. Ability to work independently and as part of a team in a fast-paced environment. 8. Familiarity with insurance company policies and procedures related to prior authorizations is a plus. 9. Commitment to maintaining patient confidentiality and adhering to HIPAA regulations. Atlantic Medical Group is a physician-led and physician-governed organization that delivers the highest quality health care, at the right place, the right price, and the right time. We are a multispecialty physician group with more than 1,000 doctors, nurse practitioners and physician assistants at over 300 locations throughout northern and central New Jersey and northeast Pennsylvania. Our mission is to deliver exceptional care recognizing the unique needs of all those we serve. Our vision is to achieve the best outcomes with our patients at the center of the physician-led team, driven by service, innovation and continuous learning. Our integrated network offers seamless access to Atlantic Health System’s entire health care continuum and our nationally and regionally ranked hospitals. In collaboration with Atlantic Health System, several of our practices offer urgent care and walk-in services. In addition to primary care physicians, the team includes specialists that care for patients in all aspects of their health from pediatrics to geriatrics and everything in between. We make health decisions easier for patients with enhanced access to referrals. EEO STATEMENT Atlantic Health System, Inc. is an equal employment opportunity employer and federal contractor or subcontractor and therefore abides by applicable laws to protect applicants and employees from discrimination in hiring, promotion, discharge, pay, fringe benefits, job training, classification, referral, and other aspects of employment, on the basis of race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, citizenship status, disability, age, genetics, or veteran status.