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Prior Authorization Specialist

Full-Time (Edina, MN)
MRO | Business Office
7401 Metro Blvd
Suite 210
Edina, MN 55439

Job Description

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 3rd 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