About the Role: Connecticut Pulmonary Specialists is looking for a detail-oriented and driven Medication Prior Authorization Coordinator to join our team in New Haven, CT. In this vital role, you'll be the key link between our patients, providers, and insurance companies — ensuring timely access to critical medications. If you thrive in a fast-paced healthcare environment and are passionate about patient advocacy, we want to hear from you!
Responsibilities:
Initiate, manage, and follow up on prior authorization requests for prescribed medications with insurance carriers
Review clinical documentation and work closely with providers to gather necessary supporting information for authorization submissions
Track and monitor authorization statuses, ensuring timely approvals and minimal treatment delays
Communicate authorization outcomes to patients, pharmacies, and clinical staff in a clear and timely manner
Manage appeals and peer-to-peer review requests for denied authorizations
Maintain accurate and up-to-date records in the electronic health record (EHR) system
Stay current on payer policies, formulary changes, and prior authorization requirements
Order patient medication - for in office adminstered medications.
Requirements:
Prior experience in medication prior authorizations, insurance verification, or healthcare administration preferred
Familiarity with pulmonology, specialty medications, or chronic disease management is a plus
Strong knowledge of insurance payer guidelines, medical terminology, and ICD/CPT coding
Proficiency with electronic health record (EHR) systems, EPIC experience is a plus
Excellent organizational skills with the ability to manage multiple cases and deadlines simultaneously
Strong written and verbal communication skills for interacting with patients, providers, and payers
High school diploma or equivalent required.
About Us: Connecticut Pulmonary Specialists is a leading pulmonary and respiratory care practice serving the New Haven, CT community with a commitment to exceptional, patient-centered care. Our patients trust us for our expertise in treating complex respiratory conditions, and our team members value the collaborative, supportive environment we've built together. We are proud to be a practice where dedicated professionals can grow their careers while making a meaningful difference in patients' lives every day.
Numbers & Facts
Location
New Haven, CT
Job Type
Full-time
Skills
Chronic Diseaseunmatched
Clinical Study Publicationsunmatched
Communication Skillsunmatched
Current Procedural Terminology (CPT)unmatched
Dental Insuranceunmatched
Detail Orientedunmatched
Disease Prevention and Controlunmatched
Epic Systemsunmatched
Formularyunmatched
Health Insuranceunmatched
Healthcareunmatched
High School Diplomaunmatched
Insuranceunmatched
International Classification of Diseases (ICD)unmatched
Medical Record Systemunmatched
Medical Terminologyunmatched
Medicationsunmatched
Organizational Skillsunmatched
Patient Careunmatched
Prescription Drugsunmatched
Presentation/Verbal Skillsunmatched
Pulmonary Diseaseunmatched
Quality of Careunmatched
Respiratory Medicineunmatched
Respiratory Therapyunmatched
Team Playerunmatched
Time Managementunmatched
Writing Skillsunmatched
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