Prior Authorization Specialist

Minneapolis Radiation Oncology has an opening for a Prior Authorization Specialist position at our Business Office in Edina. Hours are 7:30 am to 4:00 pm, Monday through Friday, starting full-time in our Edina Business Office. The ability to work a hybrid schedule with 1-2 days per week remotely is an option once fully trained after approximately 3 to 6 months.

• 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 and interpret complex 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 3rd party vendors
• Work with various business office departments and clinics to streamline processes and ensure timely accurate billing

MUST HAVE previous recent experience submitting prior authorization requests to insurance carriers.

Prefer previous understanding of billing, coding, insurance carriers and/or radiation oncology.

Excellent computer skills required with Microsoft Office programs and Electronic Medical Record (EMR) software are required in order to navigate quickly through multiple systems and websites.

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.

Annual Influenza (flu) vaccination is required, unless approved by MRO for a medical or religious exemption. Contact MRO Human Resources for more information.

Hourly pay rate starts at approximately $23-25 per hour, based on experience and qualifications. Excellent benefits package includes generous paid vacation, sick time and holidays; health, dental, vision and disability insurance coverage; 401k with profit sharing; and more!