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Full-time
high school
Posted 81d ago
~40 hrs/week
Responsibilities
The specialist coordinates insurance prior authorizations for patient prescriptions by liaising between providers, insurance companies, and patients. They monitor work queues, verify eligibility, and provide clinical information to resolve authorization issues.
Requirements
Candidates must be a high school graduate with at least one year of experience in a healthcare practice setting. Previous experience as a Medical Assistant or in prior authorizations is preferred.
Full job description
St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care.
The Medication Prior Authorization Specialist is responsible for the coordination of insurance prior authorizations for applicable patient prescriptions. This role liaises with providers, insurance companies, and patients to perform insurance verification, obtain prior authorizations, and bring the authorization process to resolution.
JOB DUTIES AND RESPONSIBILITIES:
Monitors prior authorization work queues WQ(s) and promptly obtains and/or reviews patient insurance information and eligibility verification required to secure medication prior authorizations.
Utilizes online, fax, and telephony pathways to obtain prior authorizations from insurance companies for prescribed medications and documents medication prior authorizations in the medical record as necessary.
Seeks additional information and/or communicates updates to patients and providers as appropriate throughout the prior authorization process.
Engages insurance company representatives and provides required clinical information to secure prior authorization, when necessary.
Engages practice operations and incorporates clinical care team when prior authorization attempt is unsuccessful and/or a peer-to-peer and/or alternative medication is required.
Escalates complex prior authorization issues to Supervisor, Medication Prior Authorization for assistance/guidance.
Maintains working knowledge of St. Luke’s electronic medical record system, internal systems and tools, and other online insurance websites.
Maintains solution-oriented/creative mindset to effectively anticipate and tend to patient needs by partnering with other organizational team members/departments.
Actively participates in performance improvement and continuous quality improvement activities.
Other related duties as assigned.
PHYSICAL AND SENSORY REQUIREMENTS:
Sitting for up to 8 hours per day, 3 hours at a time. Consistent use of hands and fingers for typing, telephones, data entry, etc. Occasional twisting and turning. Uses upper extremities to lift and carry up to 15 pounds. Stoops, bends, and reaches above shoulder level to retrieve files. Hearing as it relates to normal conversation. Seeing as it relates to general vision. Visual monotony when reading reports and reviewing computer screen.
EDUCATION:
High School graduate or equivalent.
TRAINING AND EXPERIENCE:
Required:
One year practice-based experience or in a similar healthcare setting.
Preferred:
Customer service experience.
Previous prior authorization experience.
Previous Medical Assistant experience.
Please complete your application using your full legal name and current home address. Be sure to include employment history for the past seven (7) years, including your present employer. Additionally, you are encouraged to upload a current resume, including all work history, education, and/or certifications and licenses, if applicable. It is highly recommended that you create a profile at the conclusion of submitting your first application. Thank you for your interest in St. Luke's!!
In 2025, the U.S. Department of Health and Human Services ranked St. Luke’s #1 – ahead of Houston Methodist and Mayo Clinic – as the nation’s top health system for quality, safety and patient experience. This objective recognition based on hospital data reported to the government reaffirms St. Luke’s preeminent position as a leader among the largest and most respected health care providers in the country. ✨
Offices: 801 Ostrum Street, Bethlehem, PA 18015, US · 1872 St Luke's Blvd, Easton, Pennsylvania 18045, US · 1021 Park Avenue, Quakertown, PA 18951, US · 1736 Hamilton Street, Allentown, PA 18103, US · 360 West Ruddle Street, Coaldale, PA 18218, US
OncologyCardiology/Cardiovascular SurgeryNeuroscienceOrthopedicsLevel 1 and Level IV Adult Trauma CenterObstetrics/Perinatal CareBariatric SurgeryRadiologyWomen's/Children's HealthRobotic/Minimally Invasive Surgery:
Frequently asked questions
How many Customer Service & Support jobs are open in Allentown, PA right now?
There are currently 683 open customer service & support positions in Allentown, PA listed on Clera. New openings are added daily as companies post roles.
Which companies are hiring for Customer Service & Support roles in Allentown, PA?
Companies currently hiring include Lehigh Valley Health Network, St. Luke's University Health Network, CVS Health, AutoZone, Domino's, among others. Browse the listings above to see every active employer.
Are there remote or hybrid Customer Service & Support jobs in Allentown, PA?
Yes — 59 of the 683 open customer service & support positions offer remote or hybrid work (40 remote, 19 hybrid).
How do I apply for Customer Service & Support jobs in Allentown, PA?
Each listing links directly to the employer's application page. Apply early — fresh listings get the most recruiter attention in the first two weeks.