Providence Health & Services Prior Authorization Specialist - Radiation Oncology in Anchorage, Alaska
Providence is calling a Prior Authorization Specialist (Radiation Oncology, Day Shift, 1.0 FTE) to Providence Alaska Medical Center in Anchorage, Alaska. We are a community of caregivers delivering every day on our Mission to provide compassionate care that is accessible for all - especially those who are poor and vulnerable.
In this position, you will:
Be proficient in the principle duties or functions of one or more treatment prior authorization functional areas including prior authorizations, appeals, and audit/training..
Act as a resource and contact for the Prior Authorization Service and provides technical assistance to the clinic staff and/or physicians on patient's coverage, authorization guidelines and procedures, claims research, and department operating procedures.
Use and understand different insurance company websites. .
Receive and appropriately triage phone calls from clinics needing assistance.
Process all paperwork/forms related to treatment prior authorizations, including electronic distribution
Verify member eligibility as required to process treatment prior authorizations and work with clinic staff as necessary to obtain required information.es.
Review patient chart to obtain documentation supporting medical necessity of requested treatments.
Required qualifications for this position include:
High School diploma or equivalent
2 years in a medical clinic or management care/health insurance plan
Experience in database management and spreadsheets
Working knowledge of coding, medical terminology, insurance billing, claims and managed care principles required.
Preferred qualifications for this position include:
Bachelors Degree in related field
3 years experience in an area such as prior authorization, medical audits, appeals or delegation
CMA or MA with clinic experience working in a clinic setting
Epic Software experience
About Providence Alaska Medical Center
Providence Health & Services Alaska is among nation’s best employers for healthy lifestyles! The National Business Group on Health, a non-profit association of large U.S. employers, has honored Providence Alaska for its commitment and dedication to promoting a healthy workplace and encouraging our caregivers (employees) and families to support and maintain healthy lifestyles. Mountain-Pacific Quality Health has awarded Providence Alaska Medical Center with its Quality Achievement Award for high-quality care in the areas of heart attack, heart failure, pneumonia and surgical infection prevention. This is the highest honor awarded by Mountain-Pacific.
As the state’s largest hospital, Providence Alaska Medical Center provides full-service, comprehensive care to all Alaskans, a role unmatched by any other in the state. Within our community, you will find top notch ski resorts, kayaking, and wildlife. Enjoying the outdoors is just one of many reasons to live in and explore Alaska!
We offer a full comprehensive range of benefits - see our website for details
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Coding
Req ID: 248777