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Prior Authorization Specialist

1 month ago

Edina, United States Minneapolis Radiation Oncology, PA Full time

Minneapolis Radiation Oncology has an opening for a Prior Authorization Specialist position at our Business Office in Edina. This is a full-time position being added to assist the 3 current Prior Authorization Specialists. This is a full-time position, working Monday-Friday from 7:30 am to 4:00 pm. Duties and Responsibilities Obtains 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 radiation treatment planning information and 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 3 rd party vendors Work with various business office departments to streamline processes and ensure timely accurate billing Qualifications Relevant work experience working in clinical radiation therapy or working with prior authorizations, medical billing or coding, appeals or health insurance carriers is required. Computer proficiency with Microsoft Office programs and Electronic Medical Record (EMR) software is required 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 COVID vaccination and annual Influenza (flu) vaccination is required, unless approved by MRO for a medical or religious exemption #J-18808-Ljbffr