Remote Chemotherapy Prior Authorization Specialist

US Oncology Network-wide Career Opportunities; Henderson (NV); Remote; USD 55,000 - 75,000; Full time

Job summary

Comprehensive Cancer Centers of Nevada (CCCN) is seeking a Remote Insurance Reviewer - Clinical (Treatment Prior Authorization Specialist) for Southern Nevada. You will review chemotherapy regimens, obtain pre-certifications, and assist patients and staff with authorization and reimbursement processes.

The role involves staying up to date with payer guidelines, coordinating with clinicians, and supporting the pathway for timely and compliant cancer treatment approvals.

Qualifications

• High school degree or equivalent.
• Associates degree in Healthcare, LPN license and registration preferred.
• Minimum three (3) years medical insurance verification and authorization required.

Responsibilities

• Reviews and processes medical necessity for chemotherapy treatment and regimen documentation.
• Communicates with nursing and medical staff regarding insurance restrictions and payer issues.
• Obtains insurance authorization and pre-certification for chemotherapy services.
• Researches additional resources to prevent denials and assists patients with reimbursement questions.

Education

High school degree or equivalent

Associates degree in Healthcare, LPN license preferred

Job description

Comprehensive Cancer Centers of Nevada (CCCN) is seeking a Remote Insurance Reviewer - Clinical (Treatment Prior Authorization Specialist) for Southern Nevada. You will review chemotherapy regimens, obtain pre-certifications, and assist patients and staff with authorization and reimbursement processes.

The role involves staying up to date with payer guidelines, coordinating with clinicians, and supporting the pathway for timely and compliant cancer treatment approvals.