Oregon Urology Institute

Medical Prior Authorization Specialist Jobs at Oregon Urology Institute

Medical Prior Authorization Specialist Jobs at Oregon Urology Institute

Sample Medical Prior Authorization Specialist Job Description

Medical Prior Authorization Specialist

Oregon Urology Institute is seeking a full time Medical Prior Authorization Specialist.

Oregon Urology Institute is one of the largest, most advanced urological centers in the Northwest. Oregon Urology Institute provides patients with some of the region's finest medical experts covering every major urological specialty using proven and leading-edge technologies such as robotic surgery, immunotherapy, and radiation therapy.

We are looking for someone with excellent skills as Medical Prior Authorization Specialist to join our team. This role will obtain all required authorizations prior to services being rendered at OUI and outside facilities. Verification of insurance coverage and benefits prior to service being rendered and request prepayment if applicable.

Essential Job Functions:

  • Verify Insurance of all scheduled patients
  • Perform benefit inquiries to determine estimated out of pocket expense
  • Notify patient of prepayment requirement and follow up as needed
  • Contact insurance carriers to obtain authorizations
  • Provide Good Faith Estimates to self-pay patients and discuss prepayment requirements
  • Review and take corrective action on rejected and denied claims in a timely manner
  • Stay current on insurance policies and practices for Authorizations and Benefits
  • Communicate daily with other departments to ensure scheduled and add-on services are covered
  • Maintain positive relationships with Scheduling, Reception and Clinical Staff including Physicians
  • Perform other duties and special projects as assigned by Supervisor or Manager


  • Knowledge of CPT & ICD10 coding and insurance reimbursement practices
  • Ability to review, understand and extract relevant information from EMR
  • Strong communication skills, both written and verbal
  • Attention to detail and ability to multitask in a demanding environment
  • Ability to work both independently and as a team
  • Desire to strengthen skills and learn
  • Equivalent of a high school diploma


  • Experience working in a windows based EMR/PM
  • Minimum of 1-3 years' experience working in a relatetd medical office role preferred
  • Working knowledge of healthcare insurance.

NOTE: This job description is not intended to be all-inclusive. Employee may perform other related duties as negotiated to meet the ongoing needs of the organization.

All new employees must be fully vaccinated for COVID-19 and able to provide proof on their first day of work. All candidates must pass a drug screen and background check in order to be considered for employment.

This is a Full-time position. We offer competitive wages with employer paid health, dental, vision. and we offer voluntary benefits. Excellent Retirement. The position pays $17.27 to $25.96 DOE

For full consideration, please apply: https://oregonurology.applicantpool.com/jobs/

Oregon Urology Institute is an equal opportunity employer that is committed to fair and impartial treatment of employees, job applicants, and contractors, and to maintaining a discrimination and harassment-free work environment where people treat one another with respect. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.

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