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Prior Authorization Specialist
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Minneapolis Radiation Oncology, P.A.
Remote
$49,920 Salary, Full-Time
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Job Description
Minneapolis Radiation Oncology has an opening for a Prior Authorization Specialist position at our Business Office in Minneapolis (near the Edina area). Hours are 7:30 am to 4:00 pm, Monday through Friday, starting full-time in our Edina Business Office. The ability to work a hybrid schedule with 1-2 days per week remotely is an option once fully trained after approximately 3 to 6 months.
Duties and Responsibilities:
- Obtain prior approval from patient's health insurance plan before moving ahead with radiation treatments or procedures to ensure health insurance claims are processed and paid correctly
- Communicate internally with clinic personnel to obtain and interpret complex radiation treatment planning information and quickly facilitate prior authorizations and appeals for pre-service denials if needed
- Complete medical necessity paperwork and submit to/follow-up with various insurance carriers
- Review and appeal rejected claims
- Spend significant time on the phone talking to insurance companies and 3rd party vendors
- Work with various business office departments and clinics to streamline processes and ensure timely accurate billing
Requirements:
MUST HAVE
previous recent experience submitting prior authorization requests to insurance carriers.- Prefer previous understanding of billing, coding, insurance carriers and/or radiation oncology.
- Excellent computer skills with Microsoft Office programs and Electronic Medical Record (EMR) software are required to be able navigate a variety of systems and websites quickly.
- Excellent written and verbal communication skills to speak with health insurance carriers, medical professionals, patients and/or business office co-workers.
- Ability to reliably multi-task, pay attention to details, follow through and problem solve are required.
- Annual Influenza (flu) vaccination or wearing a mask during the flu season is required Hourly pay rate starts at approximately $23-25 per hour, based on experience and qualifications.