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Prior Authorizations Specialists - Healthcare

    • Job Tracking ID: 512708-837533
    • Job Location: Scarborough, ME
    • Job Level: Mid Career (2+ years)
    • Level of Education: High School/GED
    • Job Type: Full-Time/Regular
    • Date Updated: November 17, 2022
    • Years of Experience: 2 - 5 Years
    • Starting Date: ASAP
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Job Description:

Do you have experience in health care prior-authorizations? Are you looking to work from home with company-provided equipment and an internet stipend? Do you want a good work-life balance with paid time off up to 3.5 weeks in your first year plus 10 paid company holidays?  Do you take pride in knowing that you are making a difference every day in the lives of people with cancer and blood disorders? If you are then look no further than New England Cancer Specialists (NECS), a proud Dana Farber affiliate.

NECS is currently seeking a full-time, Monday-Friday remote Prior Authorization Specialist. Our Prior Authorization Specialists are responsible for acquiring insurance prior authorizations for all NECS patients, as directed through dedicated physician teams. This position makes substantial outbound calls to insurance companies and utilizes multiple insurance online payer portals to complete prior authorizations primarily for imaging, inpatient admissions, second opinions, specialty labs, and procedures. The ideal candidate will be comfortable answering multi-line phone systems, triaging calls, resolving issues, and answering questions from patients and insurance companies. They will be able to take detailed messages and redirect / forward calls as necessary. Our Prior Authorization Specialists maintain confidentiality, meet deadlines to advance patient care promptly, demonstrate superior customer service skills and the ability to be effective team players as well as function at high levels independently.

This position is primarily remote, with training and coverage as needed on-site in Scarborough ME.  

NECS is a private medical practice composed of 13 oncologists and hematologists serving the region from 5 different locations in Maine and New Hampshire. Our mission is to make life better for people with cancer and blood disorders. Kindness, compassion, and respect are part of everything that we do - from our phone operators to our physicians, every person on our team is important, and everyone makes a difference. We are proud to be the first Dana Farber Affiliate practice in the country, striving to provide the highest quality care and unmatched, holistic support for every patient, every day.

Job Duties:

  • Complete prior authorizations for all tasked orders. Communicate clearly with physicians and physician-lead teams any issues or delays in the completion of tasks/authorizations.
  • Documents clearly and accurately within the Electronic Medical Record.
  • Schedules appointments with patients for authorized orders, either by phone or in-person after an office visit, following all scheduling guidelines. Works within EMR, ensuring appointments are scheduled to match physician/clinician/procedure availability with patient’s preferences in terms of date and time.
  • Collects and submits clinical information to insurance companies. Writes appeal letters to insurance companies as needed.
  • Communicates clearly and professionally to patients and staff. Accurately communicates all necessary instructions for upcoming appointments, scans, or procedures to patients.
  • Returns all phone calls by the end of the same business day.
  • Communicates consistently and frequently with provider teams, and changes to or effecting patient's care plan to ensure the best possible care for every patient. Actively participates in weekly team meetings.
  • Scans medical records according to NECS guidelines.
  • Sorts and routes incoming mail and faxes for the prior authorization department.
  • Successfully maintain a pleasant, professional demeanor under stressful conditions while working with a wide range of patient personalities.
  • Supports Medical Records by scanning documents into the EMR.
  • Other duties as assigned by the Office Manager.

Travel: Occasional to Scarborough, ME Clinic is required.

Experience and Skills:

  • High school diploma or GED required.
  • Minimum one year in Medical Prior Authorizations required, with experience is oncology or specialty medicine perfferd
  • Knowledge and application of medical terminology required.
  • Previous experience with electronic medical record systems required.
  • Exceptional customer service experience required.




New England Cancer Specialists offers competitive pay and a comprehensive benefits package to our employees.  Our benefits include medical, prescription, dental, and vision insurances.  Company-paid Life Insurance, Short Term, and Long-Term disability insurances as well as Long Term Care insurance.  Other benefits include a company-sponsored retirement program, generous Paid Time Off in addition to 10 Company-paid holidays, a Wellness Program, and other voluntary benefits.  Benefits are effective 1st of the month after your hire date.

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