Senior Clinical Prior-Authorization Specialist

Dana-Farber Cancer Institute; Brookline (MA); Sur place; USD 110 000 - 123 000; Plein temps

Résumé du poste

Dana-Farber Cancer Institute in Brookline, MA seeks a Clinical Authorization Specialist II to manage prior authorization workflows for complex cancer care, collaborating with attending physicians to resolve denials and coordinate appeals.

With minimal oversight, you will triage inquiries, provide cost estimates for waivers, mentor staff, and ensure payer-rule compliance while protecting patient confidentiality and maintaining high-quality patient service.

Qualifications

• Bachelor’s degree required; BSN preferred.
• 4 years of clinical or related experience required; 2 years in Clinical Authorization Specialist II role preferred.
• Licensed RN in Massachusetts preferred.

Responsabilités

• Manages prior authorization workflow for clinically complex cases with physicians.
• Triages and responds to payer inquiries; coordinates with clinicians to resolve denials.
• Assists in denial review, waiver cost estimates, and appeals coordination.
• Mentors staff and contributes to training materials and process improvements.

Connaissances

Payer rules knowledge

Judgment and tact

Analytical problem-solving

IT systems and MS Office

Mentoring teammates

Independent prioritization

Deadline-driven

Confidentiality

Cross-functional collaboration

Formation

Bachelor’s degree

BSN preferred

Description du poste

Dana-Farber Cancer Institute in Brookline, MA seeks a Clinical Authorization Specialist II to manage prior authorization workflows for complex cancer care, collaborating with attending physicians to resolve denials and coordinate appeals.

With minimal oversight, you will triage inquiries, provide cost estimates for waivers, mentor staff, and ensure payer-rule compliance while protecting patient confidentiality and maintaining high-quality patient service.