Prior Authorization Specialist

OneOncology; Huntsville (AL); On-site; USD 40,000 - 54,000; Full time

Job summary

Clearview Cancer Institute in north Alabama is seeking a Prior Authorization Specialist to ensure timely and accurate authorizations for patient treatments. You will work in the billing department, coordinating with physicians and nursing staff to obtain approvals from health plans.

The role emphasizes organization, independence, and familiarity with oncology medications and online portals to review policies and secure authorizations.

Qualifications

• Knowledge of health insurance plans and coverage details.

Responsibilities

• Track, obtain, and extend prior authorizations from carriers promptly.

Skills

Health insurance knowledge

Prior authorization experience

Online portals navigation

Organized and efficient

Prioritization and time management

Independent work

Education

HS diploma or equivalent

Pharmacy Technician certification preferred

Oncology experience

Oncology medications familiarity

Prior authorization experience preferred

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 Purpose

The purpose of the Prior Authorization Specialist is to ensure all necessary prior authorizations have been obtained in an effective and efficient manner.

Essential Job Functions

• Responsible 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.

Qualifications

• Must have knowledge of Health Insurance Plans
• Experience 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/Experience

• Must have a high school diploma or equivalent.
• Certified Pharmacy Technician preferred, but not required
• Oncology experience required
• Familiarity with oncology medications preferred
• Prior Authorization experience preferred

Working conditions

This position works in the billing department of a busy oncology/hematology/radiation/urology clinic. This person generally only has contact with patients via phone.

Physical requirements

This 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 Reports

This position is not a supervisory position.