Prior Authorization Specialist

We are seeking a dedicated Patient Care Specialist to join our team. In this role, you will handle a high volume of prior authorizations for patients, utilize EMR systems such as ModMed for patient records, and ensure an exceptional patient experience from arrival to departure. You will play a crucial role in maintaining efficient office operations and supporting healthcare providers.

• Welcome patients as they arrive, ensuring they feel comfortable and informed.
• 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 time of service.
• Confirm eligibility of various patient insurance plans.
• Obtain referrals as needed.

• Experience with EMR systems, particularly ModMed.
• Prior experience with prior authorizations.
• Knowledge of insurance verification processes.
• Strong customer service skills.
• Experience in surgical scheduling.

• Proven EMR experience.
• Comprehensive knowledge of insurance processes and verifications.

The position is based in the Sparta office, where you will work a Monday to Friday day shift, starting between 7:15-8:00 am, with hours from 7:30 am to 3:30 pm or 8:00 am to 4:00 pm. You will occasionally work a Saturday and Sunday shift (8:00 am - 12:00 pm) approximately 4-5 times a year and receive a day off during the week in exchange. The workplace offers a large network with a small group feel, including 80+ employees. Enjoy perm perks such as a 401K match, high PTO packages, and good bonding activities with yearly parties.

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

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)

This is a fully onsite position in Sparta,NJ.

This position is anticipated to close on Dec 24, 2025.

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 actalentaccommodation@actalentservices.com for other accommodation options.