Prior Authorization Specialist

Astera Cancer Care; Hillmont (AL); On-site; USD 36,000 - 54,000; Full time

Job summary

Clearview Cancer Institute in north Alabama is seeking a Prior Authorization Specialist to ensure all required authorizations are obtained efficiently within a busy oncology billing environment.

Responsibilities include tracking and extending authorizations with carriers, coordinating with physicians and RNs, and verifying alignment of treatments and authorizations for proper insurance payments. This role emphasizes organization, independent work, and adherence to timelines.

Qualifications

• Knowledge of health insurance plans.
• Experience obtaining health plan prior authorizations via online portals, phone, or fax.
• Ability to navigate health plan websites for medical policy review.
• Be organized and efficient.
• Ability to prioritize and complete tasks in a timely manner.
• Ability to follow directions and work independently.
• High school diploma or equivalent.
• Certified Pharmacy Technician preferred, but not required.
• Oncology experience required.
• Familiarity with oncology medications preferred.
• Prior authorization experience preferred.

Responsibilities

• Track, obtain, and extend authorizations from various carriers in a timely manner.
• Check daily, weekly, and monthly schedules for prior authorizations and request necessary authorizations.
• Communicate with physicians and RNs regarding treatment.
• Check previous patient treatment with current treatment to ensure insurance payments and prior authorizations have been entered/approved.
• Other duties as assigned.

Skills

Insurance knowledge

Prior authorizations

Organization

Time management

Independent worker

Communication with physicians

Education

High school diploma

Job description

Clearview Cancer Institute is north Alabama's leading cancer treatment facility. For over 30 years Clearview Cancer Institute has provided leading-edge treatment and compassionate care to those diagnosed with cancer or blood disorders. Clearview offers every service and amenity needed in an outpatient setting and our dedication to research and involvement in Phase I-IV clinical trials gives our patients the opportunity to receive potentially life-saving treatment options.Why Join Us? We are looking for talented and highly-motivated individuals who demonstrate a natural desire to support the meaningful work of community oncologists and the patients we serve.Job Description:Job PurposeThe purpose of the Prior Authorization Specialist is to ensure all necessary prior authorizations have been obtained in an effective and efficient manner.Essential Job FunctionsResponsible for tracking, obtaining, and extending authorizations from various carriers in a timely manner.Check daily, weekly, and monthly schedules for prior authorizations and request necessary authorizations.Communicate with Physicians and RN’s regarding treatment.Check previous patient treatment with current treatment to ensure insurance payments and prior authorizations have been entered/approved.Other duties as assigned.QualificationsMust have knowledge of Health Insurance PlansExperience in obtaining Health Plan Prior Authorizations thru online portals and/or by phone or fax.Ability to navigate Health Plan websites for medical policy review regarding services.Must be organized and efficient.Must be able to prioritize and complete tasks in a timely manner.Must be able to follow directions and/or work independently.Education/ExperienceMust have a high school diploma or equivalent.Certified Pharmacy Technician preferred, but not requiredOncology experience requiredFamiliarity with oncology medications preferredPrior Authorization experience preferredWorking conditionsThis position works in the billing department of a busy oncology/hematology clinic. This person generally only has contact with patients via phone.Physical requirementsThis position requires that the employee be able to sit at a desk in front of a computer for up to eight hours a day. Some walking and standing may be required to complete tasks.Direct ReportsThis position is not a supervisory position.