Prior Authorization Representative at RPCI Oncology PC

Town of Amherst, New York, United States -

Full Time

Start Date

Immediate

Expiry Date

20 Apr, 26

Salary

0.0

Posted On

21 Jan, 26

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Customer Service, Insurance Verification, Data Entry, Medical Terminology, Precertification, Scheduling, Confidentiality, MS Office, Communication, Attention to Detail

Industry

Medical Practices

Description

Description 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 You will be responsible for providing accurate and complete data input for precertification requests, oral medications and procedures and for providing excellent customer service. 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 Requirements Education/Experience: 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

The Prior Authorization Representative is responsible for providing accurate data input for precertification requests and delivering excellent customer service. This includes answering calls, obtaining insurance verifications, and scheduling procedures.