CENTRAL CARE CANCER CENTER
Prior Authorization Nurse Specialist
CENTRAL CARE CANCER CENTER, Bolivar, Missouri, United States, 65613
Central Care Cancer Center is hiring a Prior Authorization Nurse Specialist to join their billing team in Bolivar, MO. This position is expected to work in-clinic 5 days per week Monday-Friday 8:00 AM - 4:30 PM.
The Prior Authorization Nurse Specialist will work closely with the clinical staff and billing department. This role combines clinical and administrative functions, working closely with both the clinical staff and billing department to ensure accurate and timely insurance authorizations. The ideal candidate will bring nursing experience to the prior authorization process and serve as a resource for clinical questions that arise during billing and insurance reviews.
Essential Functions
Verify patient insurance benefits, eligibility, and demographic information accurately Submit, obtain, and track insurance authorizations for oncology treatments and medications Assist billing and prior authorization staff with clinical interpretation of orders and insurance requirements Respond to clinical questions related to diagnosis, treatment plans, and payer guidelines Help patients understand their insurance coverage, authorizations, and financial responsibilities Review patient accounts and assist with setting up payment agreements Coordinate with providers to obtain additional documentation when needed Support patients in identifying and applying for financial assistance programs Collaborate with interdisciplinary teams to improve patient access to care Job Experience
Active RN or LPN license required Experience with prior authorizations and insurance processes strongly preferred Oncology or infusion experience a plus Working knowledge of Medicare, Medicaid, HMOs, PPOs, and secondary payers required Experience with EMRs Proficiency with Microsoft Word and Excel Excellent communication, organizational, and multitasking skills Ability to work independently while collaborating effectively with clinical and administrative teams More about Bolivar, Missouri
Bolivar
boasts the best of all worlds: thriving businesses, awarding-winning schools, a first-class university, state-of-the-art medical facilities, compassionate churches, active civic organizations, peaceful parks and limitless recreational opportunities. Conveniently located on newly-expanded Highway 13 between Kansas City and Springfield, our town of 10,000 offers you the benefits of a bustling metropolis partnered with the peace and serenity you’ll only feel in a rural setting. As of the 2010 census, the population was 10,325. Bolivar is a fast-growing community but still maintains a small town family atmosphere. If you’re looking for something new, shop one of our many locally-owned stores or visit the year-roundGreater Polk County Farmer’s Market . Sports enthusiasts can support the local high school and university sports teams by attending a game. Have fun at a parade or festival held regularly at the historic Bolivar square or the Polk County Fairgrounds, and Bolivar features more than 20 churches to worship in. Among the many events held annually in Bolivar are the Light The Park celebration, Arts In The Parks, the Polk County Junior Livestock Show & Youth Fair, the CMH Basketball HoopFest, the SBU Homecoming Parade, the Bolivar Christmas Parade, Taste of Bolivar, the Lawn and Garden show, Country Days, and the 4th of July Celebration of Freedom. You will be redirected to our HR portal.
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Verify patient insurance benefits, eligibility, and demographic information accurately Submit, obtain, and track insurance authorizations for oncology treatments and medications Assist billing and prior authorization staff with clinical interpretation of orders and insurance requirements Respond to clinical questions related to diagnosis, treatment plans, and payer guidelines Help patients understand their insurance coverage, authorizations, and financial responsibilities Review patient accounts and assist with setting up payment agreements Coordinate with providers to obtain additional documentation when needed Support patients in identifying and applying for financial assistance programs Collaborate with interdisciplinary teams to improve patient access to care Job Experience
Active RN or LPN license required Experience with prior authorizations and insurance processes strongly preferred Oncology or infusion experience a plus Working knowledge of Medicare, Medicaid, HMOs, PPOs, and secondary payers required Experience with EMRs Proficiency with Microsoft Word and Excel Excellent communication, organizational, and multitasking skills Ability to work independently while collaborating effectively with clinical and administrative teams More about Bolivar, Missouri
Bolivar
boasts the best of all worlds: thriving businesses, awarding-winning schools, a first-class university, state-of-the-art medical facilities, compassionate churches, active civic organizations, peaceful parks and limitless recreational opportunities. Conveniently located on newly-expanded Highway 13 between Kansas City and Springfield, our town of 10,000 offers you the benefits of a bustling metropolis partnered with the peace and serenity you’ll only feel in a rural setting. As of the 2010 census, the population was 10,325. Bolivar is a fast-growing community but still maintains a small town family atmosphere. If you’re looking for something new, shop one of our many locally-owned stores or visit the year-roundGreater Polk County Farmer’s Market . Sports enthusiasts can support the local high school and university sports teams by attending a game. Have fun at a parade or festival held regularly at the historic Bolivar square or the Polk County Fairgrounds, and Bolivar features more than 20 churches to worship in. Among the many events held annually in Bolivar are the Light The Park celebration, Arts In The Parks, the Polk County Junior Livestock Show & Youth Fair, the CMH Basketball HoopFest, the SBU Homecoming Parade, the Bolivar Christmas Parade, Taste of Bolivar, the Lawn and Garden show, Country Days, and the 4th of July Celebration of Freedom. You will be redirected to our HR portal.
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