Prior Authorization Specialist - Radiation Oncology
About The Position
Work where every moment matters. Every day, almost 40,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut’s most comprehensive healthcare network. The Hartford HealthCare Cancer Institute focuses on offering our cancer patients an unparalleled network of coordinated services– all under one roof. Our system of care includes a truly integrated team with the most talented, experienced, and compassionate caregivers and physicians, backed by the latest cutting-edge technology. The Prior Authorization Specialist is responsible for processing and submitting authorizations, also in correspondence with providers, patients, insurance companies, specialists and other healthcare representatives. The Prior Authorization Specialist ensures that all referrals and authorizations are documented completely and submitted in a timely manner.
Requirements
- High school diploma or equivalent
- 2 years minimum working with insurance authorization with knowledge of CPT and ICD-10 coding practices and medical terminology
Nice To Haves
- Experience working with oncology strongly preferred
Responsibilities
- Initiates prior authorizations for medical procedures, tests, and prescriptions as requested by staff, providers, and/or insurers.
- Documents all prior authorization activities and record activity in the practice management system.
- Prioritizes and organizes all prior authorization activities.
- Serve as liaison between patient and insurer & patient and practice.
- Work on denials and write off’s.
- Prints and reviews the appointment scheduler up to three (3) days in advance to ensure proper obtaining of authorizations, pre-certifications and referrals prior to services being rendered for patients as required by the different insurance plans/carriers.
- Identifies self-pay patients.
- Identifies and resolves problems within the scope of the job duties.
- Notifies appropriate parties (management) of any situation or issue that is out of the ordinary.
Benefits
- competitive benefits program designed to ensure work/life balance
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
