• Prior Authorization Specialist

    Actalent (Wharton, NJ)


    Job Title: Prior Authorization Specialist

    Job Description

    We are seeking a dedicated Medical Office Specialist to manage patient prior authorizations and ensure seamless office operations. The role involves using ModMed as the electronic medical records (EMR) system, welcoming patients, and maintaining accurate patient records.

    Responsibilities

    + Handle a high volume of prior authorizations for patients.

    + Utilize ModMed as the EMR for patient records.

    + Welcome patients as they arrive, ensuring they feel comfortable and informed.

    + Authorize procedures and medications.

    + Obtain benefits and eligibility for patients.

    + Manage the appointment calendar, schedule patient visits, and coordinate with medical staff availability.

    + Handle incoming calls, direct them to the appropriate personnel, and address patient inquiries.

    + Verify patient insurance coverage and collect copayments.

    + Assist patients with check-in and check-out procedures, ensuring all necessary forms are completed.

    + Maintain and update patient records, ensuring confidentiality and accuracy.

    + Process insurance claims, create invoices, and manage patient billing.

    + Assist with patient examinations, take vital signs, and prepare patients for procedures.

    + Update and maintain accurate patient medical histories and records.

    + Provide patients with information on treatments, medications, and post-procedure care.

    + Order and manage medical supplies and equipment.

    + Work with healthcare providers to ensure smooth patient flow and efficient office operations.

    + Perform data entry of basic demographics and insurance information.

    + Collect applicable co-payment/account balances at the time of service.

    + Confirm eligibility of various patient insurance plans.

    + Obtain referrals as needed.

    Essential Skills

    + EMR experience

    + Patient care

    + Insurance verification

    + Healthcare experience

    + Recent prior authorization experience

    + Knowledge of insurances and verifications

     

    Additional Skills & Qualifications

     

    + Customer service

    + Surgical scheduling

    Work Environment

    The role is based in the Sparta office. You will work a Monday to Friday day shift, starting between 7:15-8 am, with hours from 7:30 am to 3:30 pm or 8 am to 4 pm. Approximately 4-5 times a year, you will work a Saturday and Sunday shift from 8 am to 12 pm and receive one day off during the week. The work environment is highly praised, with positive feedback from consultants. Despite being part of a large network with seven offices, there is a small group feel. Permanent employees enjoy benefits such as a 401K match, generous PTO packages, bonding activities, and yearly parties. The company boasts a team of over 80 employees across all skillsets.

     

    Job Type & Location

     

    This is a Contract to Hire position based out of Wharton, NJ.

    Pay and Benefits

    The pay range for this position is $18.00 - $21.00/hr.

     

    Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)

     

    Workplace Type

     

    This is a fully onsite position in Wharton,NJ.

     

    Application Deadline

     

    This position is anticipated to close on Jan 13, 2026.

    About Actalent

    Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

     

    The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

     

    If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email [email protected] (%[email protected]) for other accommodation options.