Prior Authorization Specialist
About The Position
Beacon Clinic is hiring a Prior Authorization Specialist to coordinate insurance approvals, prior authorizations, and appeals for patients receiving care at its clinic. The role includes working with private and government payers, including Medicare, HMOs/PPOs, and clinical trials; communicating with patients and families about treatment estimates, financial responsibilities, and payment arrangements; and verifying insurance coverage to help prevent treatment delays. The specialist prepares accurate patient account documentation for supervisor approval, supports billing compliance and proper coding, and works with providers and the patient access manager to identify and resolve financial barriers before treatment begins. The position is onsite at the Coeur d'Alene, Idaho location, with a willingness to float to other locations if needed. Beacon describes the role as offering flexible and stimulating work with meaningful advancement opportunities.
Requirements
- High school education or GED required.
- Strong written and verbal communication skills.
- Comfortable communicating by phone.
- Ability to work extremely well in a group setting.
- Ability to interpret billing manuals, insurance, and other third-party coverage.
- Understanding of the third-party review process, payer funding and authorization procedures, and government/state payers, including eligibility factors.
- Knowledge of medical and insurance terminology.
- Ability to prioritize workload and meet tight time frames.
- Ability to work under minimal supervision with attention to detail, problem-solving skills, and follow-through.
- Ability to concentrate on detail amid other activities.
- Compassionate and caring bedside manner.
Nice To Haves
- Experience with insurance and prior authorization is strongly preferred.
- Interest in ongoing personal development, professional growth, and continuing education.
Responsibilities
- Coordinate insurance approvals, prior authorizations, and appeals with private and government payers, including Medicare, HMOs/PPOs, and clinical trials.
- Communicate with patients and families about treatment estimates and financial responsibilities, and establish payment arrangements.
- Regularly verify insurance coverage and resolve billing or reimbursement issues to avoid treatment delays.
- Prepare and document patient accounts accurately for supervisor approval, ensuring billing compliance and the use of proper codes.
- Collaborate with providers and the patient access manager to identify and resolve financial barriers before treatment begins.
- Demonstrate professionalism through self-directed work, ongoing development, and innovative problem-solving.
Benefits
- Paid time off.
- Eight paid, closed-clinic holidays.
- Health insurance, including dental and vision.
- 401(k) plan with match.
- Professional development fund.
- Employee assistance program.
- Meaningful advancement opportunities.
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What This Job Offers
Job Type
Full-time
Education Level
High school or GED
