Prior Authorization and Claims Specialist

Oregon Urology Institute has a Full-time, Prior Authorization and Claims Specialist opportunity available.

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.

This role will obtain all required authorizations prior to services being rendered and coordinate billing for Radiation Oncology services. Verification of insurance coverage and benefits prior to service being rendered and request prepayment if applicable.

Essential Job Functions:

• Verify insurance coverage and obtain service specific benefits for all scheduled patients.
• Obtain Prior Authorization for Consultations, Radiation treatment, Injections, and Imaging
• Perform benefit inquiries to determine cost estimates.
• Counsel patients on expected out of pocket expense, prepayment requirements, payment plans and account balances.
• Evaluate medical record documentation and coding to enter charges and submit claims.
• Research and act on denied and incorrectly processed claims in a timely manner.
• Support Urology Prior Authorization team by providing back-up coverage as needed.
• Cover breaks for Radiation Oncology Receptionist as needed.
• Keep current with all insurance company coding rules, authorization requirements and policy changes.
• Perform other duties as assigned.

Position requirements:

• Complies with legal standards and guidelines.
• Maintain strict confidentiality.
• Ability to review, understand and extract relevant medical information from EMR.
• Knowledge of CPT and ICD10
• Strong communication skills, both written and verbal
• Attention to detail and ability to multi-task.
• Ability to work both independently and as a team.
• Flexibility

Preferred qualifications:

• Experience working in an EMR/PM (Athena preferred)
• Experience in a related Medical Office role

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.

This is a Full-time position. Authorization and Billing Specialist wage range: $17.27 to $25.96 per hour, DOE. Oregon Urology Institute offers employees fully employer paid life, health, dental and vision, 6 paid holidays, generous PTO, voluntary benefits, and an outstanding retirement. Please apply!

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.

Current Openings for Prior Authorization and Claims Specialist Jobs at Oregon Urology Institute