Oncology & Hematology Prior Authorization Specialist

loganhealth; Kalispell (MT); On-site; USD 55,000 - 70,000; Full time

Benefits offered by this job

401(k) plan

Employee Assistance Program

Differential pay

Job summary

Logan Health in Kalispell, MT is seeking a detail-oriented Prior Authorization Specialist to obtain accurate authorizations for facility and professional charges.

You will review CPT/ICD-10 codes, gather patient information, and communicate with insurers to ensure timely approvals while maintaining HIPAA compliance.

This role requires two years of relevant experience and offers a day shift with competitive benefits and opportunities to support the revenue cycle.

Qualifications

• Minimum of two years' experience in acquiring pre-certifications or prior authorizations.
• Knowledge of commercial and government insurance requirements and HIPAA rules.
• Understanding of ICD-9 and CPT codes and reimbursement procedures.

Responsibilities

• Obtain accurate prior authorizations for facility and professional charges.
• Submit CPT/HCPCS codes and medical records to insurers timely.
• Secure patient demographics and ensure HIPAA compliance.
• Review information for completeness and coordinate with stakeholders.
• Prioritize requests and track CPT/ICD-10 accuracy.
• Maintain payer requirements and educate leadership on issues.

Skills

Prior authorization

Insurance knowledge

Communication skills

Organization

Critical thinking

HIPAA compliance

Tools

Meditech

Microsoft Office

Job description

Logan Health in Kalispell, MT is seeking a detail-oriented Prior Authorization Specialist to obtain accurate authorizations for facility and professional charges.

You will review CPT/ICD-10 codes, gather patient information, and communicate with insurers to ensure timely approvals while maintaining HIPAA compliance.

This role requires two years of relevant experience and offers a day shift with competitive benefits and opportunities to support the revenue cycle.