Prior Authorization Representative

RPCI Oncology PC • Town of Amherst, NY

2h • Hybrid

About The Position

Come and join our growing organization as a Prior Authorization Representative!

Roswell Park Care Network is a recognized leader in oncology and specialty care, supporting community physician practices across New York State. We are committed to delivering exceptional patient care while advancing innovative treatment options in a collaborative and patient-focused environment.

Why Join Roswell Park Care Network?
We offer an outstanding benefits package designed to support your professional growth and work-life balance:
Work-Life Balance: Monday–Friday schedule — no nights or weekends
Comprehensive Benefits: Medical, dental, and vision coverage
Retirement Savings: 401(k) with company match
Paid Time Off: Generous vacation and sick time
Insurance Coverage: Company-paid life insurance, with options for Long-Term Disability, Critical Illness, and Accident coverage
Hybrid Schedule: One on-site day per week after on-site training is completed
Paid Holidays: 11 recognized holidays
Responsible for providing accurate and complete data input for precertification requests, oral medications and procedures and for providing excellent customer service

Requirements

• High School diploma or G.E.D. and the equivalent of six (6) months of full-time RPCI Oncology, PC clinical OR Administrative health care experience
• Must have prior customer service experience in an office preferably with patients
• Must have experience working in Windows and with MS Office software

Responsibilities

• Answers calls from physician offices and patients using exemplary customer service skills
• Obtain insurance verification, authorizations/pre-certifications
• Scheduling of diagnostic imaging, injections, surgical procedures
• Accurately enter required information (non-clinical and structured clinical data) into computer databases
• Reviews structured data matched it against specified medical terms and diagnoses or procedure codes and follow established procedures for authorizing request or referring request for further review
• Call back providers with precertification numbers as needed and file completed precertification requests as per established procedures
• Follow-up for discharge dates as needed
• Print and send form letters correspondence as needed
• Maintain patient confidentiality as defined by state, federal and hospital regulations

Benefits

• Medical, dental, and vision coverage
• 401(k) with company match
• Generous vacation and sick time
• Company-paid life insurance, with options for Long-Term Disability, Critical Illness, and Accident coverage
• 11 recognized holidays

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED