Prior Authorization Specialist
About The Position
Beacon Clinic is seeking a Prior Authorization Specialist to coordinate insurance approvals, prior authorizations, and appeals and help patients address financial responsibilities before treatment. The role supports medical oncology, hematology, radiation oncology, rheumatology, and urology services. It involves working with private and government payers, communicating with patients and families about treatment costs and payment arrangements, and collaborating with providers and the patient access manager to resolve financial barriers and prevent treatment delays. The position is onsite in Coeur d’Alene, Idaho, and may require floating to other locations as needed.
Requirements
- High school education or GED.
- Compassionate and caring bedside manner.
- Strong written and verbal communication skills; comfort communicating by phone.
- Ability to work very well in a group setting.
- Ability to interpret billing manuals and insurance or other third-party coverage.
- Understanding of third-party review processes, 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, and follow-through.
- Ability to concentrate on detail while other activities are occurring.
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 to provide treatment estimates, discuss 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 use of proper codes.
- Collaborate with providers and the patient access manager to identify and resolve financial barriers before treatment begins.
- Work independently and demonstrate professionalism through ongoing development and innovative problem-solving.
Benefits
- Paid time off
- Eight paid holidays when the clinic is closed
- Health insurance, including dental and vision
- 401(k) plan with match
- Professional development fund
- Employee Assistance Program
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Education Level
High school or GED
