Medical Authorization Specialist

4 weeks ago


Rutland, Vermont, United States Rutland Regional Medical Center Full time

At Rutland Regional Medical Center, we are seeking a highly skilled Medical Authorization Specialist to join our team. In this role, you will be responsible for managing the prior authorization process for services within the Foley Cancer Center to ensure that patients can receive chemotherapy and other services in a timely manner.

Key Responsibilities:

  • Work closely with our providers, pharmacy, and nursing staff to ensure coverage for therapies is in place prior to treatment.
  • Independently manage denials and implement strategies to resolve issues and document and communicate relevant information.
  • Ensure high-cost drugs, biosimilars, and genetic testing requirements are satisfied prior to therapy initiation.

Requirements:

  • High School diploma or equivalent.
  • Associates Degree in a related field preferred.

Preferred Qualifications:

  • Certified Prior Authorization Specialist desirable.

Skills and Abilities:

  • Excellent verbal and written communication skills.
  • Ability to discreetly handle confidential information.
  • Demonstrated knowledge of Medical Terminology.
  • Working knowledge of cancer treatment-related medications, therapies, and terminologies.
  • Prior knowledge of 3rd party payer requirements.
  • Excellent organizational skills, with the ability to prioritize.
  • Ability to effectively work with customers from a variety of socio-economic backgrounds.
  • Demonstrated Moderate Knowledge of Basic Computer Skills.

Pay Range: $29.96



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