Prior Authorization Specialist

3 weeks ago


Scarborough, United States New England Cancer Specialists Full time

Shift: First Shift,Mon,Tue,Wed,Thu,Fri

New England Cancer Specialists is a private medical practice composed of 18 Oncologists and hematologists. Serving the State and region from 4 different locations in Maine. NECS is committed to achieving the best outcome and providing unmatched support in all areas for every patient. Nationally recognized as 1 of 10 Oncology Medical Homes in the Nation. NECS brings together top clinicians, researchers, and dedicated medical professionals, clinical and non-clinical to create the best possible experience for our patients.
- ** Job Duties**:

- Obtaining pre-authorization from insurance carriers, by phone or website for any office/outpatient procedures, scans and labs
- Schedule any necessary outpatient appointments (i.e. scans, labs, procedures, etc.)
- forward medical records to insurance carriers
- Scan documents into patient charts.
- Answers multi-line phone, triage calls, resolve issues and answer questions, redirects callers if necessary, takes detailed messages and/or forwards calls to appropriate persons.
- Manages and resolves appointment conflicts proactively.
- Prioritize work assignments, ensuring on-time completion of tasks and projects, providing updates to team members.
- Communicating with clinical staff regarding approvals and denials
- Maintain confidentiality, document all communications in computer system.
- Demonstrate superior customer service skills and ability to be an effective team player.

**Travel**: Rare.

**Experience and Skills**:

- Certificate of completion from an accredited program for CNA or Medical Assistant preferred.
- High School Diploma/GED, with two or more years of experience in a health care environment required.
- Knowledge of medical terminology and customer/patient service experience required.
- Organizational and problem-solving skills, and ability to manage multiple priorities.
- Ability to convey information both in writing and verbally. Must have high level of interpersonal skills to handle sensitive and confidential situations.
- Previous experience using an electronic medical records system required.
- Knowledge of medical insurance desired
- Knowledge of CPT and IDC-10 Coding preferred.
- Call Center Experience a plus.

**Job Benefits**:
New England Cancer Specialists offers competitive pay and benefits to our employees. Benefits include medical, prescription, dental, and vision insurances. Short Term and Long Term disability insurances. Tuition reimbursement. Generous Paid Time Off. Company paid holidays. 401(k).

Our employees donate 100% of their Friday Jeans Money back to our patients. When we wear jeans to work on Friday, we agree to donate $2.00 to help those in need. This money is distributed to the Financial Advocates in our Brunswick, Scarborough, and Kennebunk sites, and then changed into gift cards to help our patients with food, gas, and other necessity they may need assistance with.

From: New England Cancer Specialists



  • Scarborough, United States New England Cancer Specialists Full time

    Job DescriptionJob DescriptionNew England Cancer Specialists is a private medical practice composed of 18 Oncologists and hematologists. Serving the State and region from 4 different locations in Maine. NECS is committed to achieving the best outcome and providing unmatched support in all areas for every patient. Nationally recognized as 1 of 10 Oncology...


  • Scarborough, Maine, United States Maine Health Full time

    Full Time175 Route 1Clerical/Administrative SupportDay Shift Position SummaryPrior Authorization Specialist, responsible for obtaining insurance pre-approvals for medications and medical supplies. Previous experience in a medical office or healthcare setting, knowledge of medical terminology, and insurance verification process. Ability to work independently...


  • Scarborough, United States Maine Health Full time

    Full Time 175 Route 1 Clerical/Administrative Support Day Shift * Position Summary Prior Authorization Specialist, responsible for obtaining insurance pre-approvals for medications and medical supplies. Previous experience in a medical office or healthcare setting, knowledge of medical terminology, and insurance verification process. Ability to work...


  • Scarborough, United States Maine Medical Center Full time

    Summary Position Summary Prior Authorization Specialist, responsible for obtaining insurance pre-approvals for medications and medical supplies. Previous experience in a medical office or healthcare setting, knowledge of medical terminology, and insurance verification process. Ability to work independently and prioritize task effectively. This is a hybrid...


  • Scarborough, United States New England Life Care Full time

    Job DescriptionJob DescriptionNew England Life Care (NELC) is one of the fastest growing home infusion therapy companies in New England and is the region’s only non-profit home infusion provider. NELC is a hospital collaborative serving more than 60 hospital systems in Maine, New Hampshire, and Massachusetts. NELC was created by local hospitals to ensure...

  • scheduling specialist

    4 weeks ago


    Scarborough, United States CDI Corporation Full time

    RAYUS Radiology, formerly Center for Diagnostic Imaging and Insight Imaging, is looking for a Scheduling Specialist to join our team. We are challenging the status quo by shining light on radiology and making it a critical first step in diagnosis and proper treatment. Come join us and shine brighter together! As a Scheduling Specialist, you will be...


  • Scarborough, United States RAYUS Radiology Full time

    RAYUS Radiology, formerly Center for Diagnostic Imaging and Insight Imaging, is looking for a Scheduling Specialist to join our team. We are challenging the status quo by shining light on radiology and making it a critical first step in diagnosis and proper treatment. Come join us and shine brighter together! As a Scheduling Specialist, you will be...


  • Scarborough, United States MaineHealth Full time

    **Position Summary** The referral specialist will ensure patients have been cleared for an appointment by resolving pre-certification, registration, and case-related concerns prior to a patient's appointment. The referral specialist verifies insurance coverage and obtains authorization if needed from the insurance provider and provides administrative...

  • Referral Specialist

    2 weeks ago


    Scarborough, Maine, United States Maine Medical Center Full time

    Summary Position Summary The referral specialist will ensure patients have been cleared for an appointment by resolving pre-certification, registration, and case-related concerns prior to a patient's appointment. The referral specialist verifies insurance coverage and obtains authorization if needed from the insurance provider and provides administrative...

  • scheduling specialist

    2 weeks ago


    Scarborough, Maine, United States RAYUS Radiology Full time

    Job Summary RAYUS Radiology, formerly Center for Diagnostic Imaging and Insight Imaging, is looking for a Scheduling Specialist to join our team. We are challenging the status quo by shining light on radiology and making it a critical first step in diagnosis and proper treatment. Come join us and shine brighter together As a Scheduling Specialist, you will...

  • Referral Specialist

    2 weeks ago


    Scarborough, Maine, United States Maine Medical Partners Full time

    Position SummaryPrior Authorization Specialist, responsible for obtaining insurance pre-approvals for medications and medical supplies. Previous experience in a medical office or healthcare setting, knowledge of medical terminology, and insurance verification process. Ability to work independently and prioritize task effectively. This is a hybrid position...


  • Scarborough, Maine, United States MaineHealth Full time

    Position SummaryThe referral specialist will ensure patients have been cleared for an appointment by resolving pre-certification, registration, and case-related concerns prior to a patient's appointment. The referral specialist verifies insurance coverage and obtains authorization if needed from the insurance provider and provides administrative support such...

  • Referral Specialist

    4 weeks ago


    Scarborough, United States Maine Medical Partners Full time

    **Position Summary** Prior Authorization Specialist, responsible for obtaining insurance pre-approvals for medications and medical supplies. Previous experience in a medical office or healthcare setting, knowledge of medical terminology, and insurance verification process. Ability to work independently and prioritize task effectively. This is a hybrid...

  • Referral Specialist

    4 weeks ago


    Scarborough, United States Maine Health Full time

    Part Time 96 Campus Drive Clerical/Administrative Support Day Shift * Position Summary The referral specialist will ensure patients have been cleared for an appointment by resolving pre-certification, registration, and case-related concerns prior to a patient's appointment. The referral specialist verifies insurance coverage and obtains authorization if...

  • Referral Specialist

    1 month ago


    Scarborough, United States Maine Medical Center Full time

    Summary Position Summary The referral specialist will ensure patients have been cleared for an appointment by resolving pre-certification, registration, and case-related concerns prior to a patient's appointment. The referral specialist verifies insurance coverage and obtains authorization if needed from the insurance provider and provides administrative...

  • Referral Specialist

    1 month ago


    Scarborough, United States Maine Medical Center Full time

    Summary Position Summary The referral specialist will ensure patients have been cleared for an appointment by resolving pre-certification, registration, and case-related concerns prior to a patient's appointment. The referral specialist verifies insurance coverage and obtains authorization if needed from the insurance provider and provides administrative...

  • Referral Specialist

    4 weeks ago


    Scarborough, United States Maine Medical Center Full time

    Summary Position Summary The referral specialist will ensure patients have been cleared for an appointment by resolving pre-certification, registration, and case-related concerns prior to a patient's appointment. The referral specialist verifies insurance coverage and obtains authorization if needed from the insurance provider and provides administrative...


  • Scarborough, Maine, United States Collabera Full time

    Home Search Jobs Job Description Regulatory Specialist II Contract: Scarborough, Maine, US Salary: $50.00 Per Hour Job Code: End Date: Days Left: 28 days, 3 hours left Apply To discuss more about this job opportunity, please reach out to Chitrank Rastogi (LinkedIn URL - ), email your updated resume at Email - or give me a call at Thank you Job...


  • Scarborough, United States New England Life Care Full time

    New England Life Care (NELC) is one of the fastest growing home infusion therapy companies in New England and is the region’s only non-profit home infusion provider. NELC is a hospital collaborative serving more than 70 hospital systems in Maine, New Hampshire, and Massachusetts. NELC was created by local hospitals to ensure their patients have access to a...

  • Training Specialist

    2 weeks ago


    Scarborough, Maine, United States Rangam Consultants Inc. Full time

    Training Specialist / Instructional Designer in Scarborough, ME Title: Training Specialist / Instructional DesignerThe position of Quality Training Compliance Specialist is within our Infectious Disease Developed Markets business unit located at Scarborough, Maine.This role provides training support and expertise to employees to ensure continued compliance...