Prior Authorization Representative

Roswell Park Care Network is looking to hire a Prior Authorization Representative to join our team in Williamsville, NY.

The position is hybrid and only requires one day in the office each week! 

As a leading provider of oncology and specialty care in community practices, Roswell Park Care Network is committed to delivering exceptional patient care and pioneering innovative treatment solutions.  
 

We offer:

• Schedule is Monday through Friday -  Excellent Hybrid Role with Only One Day In Office!
• 401(k) with company match
• 11 Holidays
• Medical Insurance via Highmark Blue Cross Blue Shield
• HRA - employer funded
• Dental Insurance and Vision Insurance
• Company paid life insurance, options for LTD, Critical Illness, Accident
• Generous Vacation and Sick time

The Prior Authorization Representative is responsible for providing accurate and complete data input for precertification requests, oral medications and procedures and for providing excellent customer service.

Responsibilities:

• Answer calls from physician offices and patients using exemplary customer service skills
• Obtain insurance verification, authorizations/pre-certifications
• Scheduling of diagnostic imaging, injections, surgical procedures
• Accurately enter required information (non-clinical and structured clinical data) into computer databases
• Reviews structured data matched it against specified medical terms and diagnoses or procedure codes and follow established procedures for authorizing request or referring request for further review
• Call back providers with precertification numbers as needed and file completed precertification requests as per established procedures
• Follow-up for discharge dates as needed
• Print and send form letters correspondence as needed
• Maintain patient confidentiality as defined by state, federal and hospital regulations

Education / Experience:

• High School diploma or G.E.D. and the equivalent of six (6) months of full-time RPCI Oncology, PC clinical OR Administrative health care experience
• Previous customer service experience in an office setting, preferably involving patient interaction 
• Proficiency with Windows operating systems and Microsoft Office applications