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Retail Sales Associate
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PT - Framingham, MA
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Print Services Sales Associate
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Prior Authorization Specialist- Framingham, MA
1 month ago
Job Type:
Full-time
Shift:
Monday- Friday (Days)
Job Summary
Receive requests for Medical Oncology/Hematology pre-authorizations and ensure that they are properly and closely monitored. Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed. Follow prior authorization workflow, policies and procedures. Collaborate with other departments to assist in obtaining pre-authorizations in a cross-functional manner. Consult with supervisor or nurse manager to obtain clearance that treatment regimen is considered a medical necessity. Process referrals and submit medical records to insurance carriers to expedite prior authorization processes. Manage correspondence with insurance companies, physicians, specialists, and patients as required.
Qualifications/Requirements
High school diploma or equivalent is required.
Previous experience as Prior Authorization Specialist is required.
Knowledge of insurance processes and medical terminology is required.
Prior Authorization experience in an Oncology/Hematology setting is required.
EPIC knowledge is a plus
Benefits
401K
Health Insurance
Life Insurance
Dental Insurance
Vision Insurance
Paid Holidays
Many More
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