Prior Authorization Auditor

Beacon Clinic was founded for the purpose of delivering a level of care that we, as a team, can all be proud of. We are a patient-focused health and wellness clinic that is committed to providing the highest quality of medical care and supportive services. When founded, we specialized  in the treatment of cancer and blood conditions. Today, we provide medical oncology and hematology, radiation oncology, rheumatology, and urology services to our phenomenal patients. Learn more about us at our website.

Beacon has an excellent opportunity available within our clinic as a Prior Authorization Auditor assisting our Post Falls Oncology team. If you are looking for exciting, flexible, and stimulating work with meaningful advancement opportunities available, then consider Beacon the right place for you!

Duties/Responsibilities:  

• Confirm diagnosis codes are added correctly, auth and referrals are in payment system for billing.


• Confirm financial estimates are given to patient and signed.


• Verify that authorizations matches insurance and no new plan was added.


• Validate Insurance is active, no other insurance, coordination of benefit if done etc.


• Confirm acknowledgement is in UF for co pay collection, insurance cards needed, etc.


• Check for older claims more than 120 days.


• Check for high patient responsibility charges.


• Make sure drug j-codes did not change.


• Confirm letter of approval is in chart from insurance company.

Required Skills/Abilities:

• Compassionate and caring bedside manner.


• Strong written and verbal communication skills, comfortable on phone.


• Ability to work extremely well in a group setting.


• Ability to interpret billing manuals, insurance and/or other third-party coverage.


• Understanding of the third-party review process, payer funding and authorization procedures to ensure payment, and government/state payers, including eligibility factors.


• Knowledge of medical and insurance terminology is required.


• Ability to work under minimal supervision, with detail and possess problem-solving and follow-through skills.
  

Education: 

• High school education or GED required 

• Experience with Insurance and Prior Authorization strongly preferred 

Physical Requirements 

• Prolonged periods of sitting at a desk and working on a computer. 

• Must be able to lift up to 15 pounds at times. 

Location

• 3815 N Schreiber Way, Suite 101, Coeur d'Alene, ID 83815
  
  
  
  • Willing to float to other locations if needed
    
  
  
  
  

Benefits

• Paid Time Off


• 8 paid, closed-clinic holidays


• Health Insurance, including dental and vision


• 401(k) Plan with match


• Professional Development Fund
  


• Employee Assistance Program

Beacon Company Mission: To meet patients wherever they are on their cancer journey and walk with them on that journey; to provide compassionate, personalized cancer care for an unparalleled patient experience.

Beacon Core Values: Compassion. Grace. Honesty. Humor. Respect. Trust.

Our providers and staff at Beacon share these values and truly embody the mission of Beacon. Our team is comprised of the most devoted, compassionate individuals who consistently go above and beyond for patients and who strive to continually improve patient care and the overall patient experience.