Prior Authorization Specialist

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 three Prior Authorization Specialists. This is a full-time position, working Monday-Friday from 7:30 am to 4:00 pm.

Duties and Responsibilities

• Obtain 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