Prior Authorization Specialist - Oncology (Remote From Maine)

Position Summary

The Prior Authorization Specialist will ensure all tasks related to obtaining insurance authorizations for diagnostic imaging test and/or procedures meet defined performance metrics.

Additional services requested include:

• Radiology (Ultra Sounds, MRIs, CTs, CT Guided Biopsies)
• Nuclear Medicine (Bone Scans, PET CT Imaging, DEXA Scans)
• Interventional Radiology (Port placements and removals)
• Cardiology (Echos)
• IV Therapy treatments (Chemotherapy, Hematology, and Immunotherapy)
• Lumbar Punctures
• Genetic Testing (blood lab draws testing for genetic variants)

Preferred Requirements:

• Prior authorization experience.
• Understand and be open to continued education on insurance guidelines, procedures, and restrictions regarding the standard of care for Oncology and Hematology patients.
• Excellent communication and interpersonal skills with the ability to communicate clearly in person and on the phone.

Required Minimum Knowledge, Skills, and Abilities (KSAs)

• Education: High school graduate or equivalent preferred.
• License/Certifications: N/A
• Experience: Previous medical office experience.
• Knowledge of managed care and medical office billing procedures.
• Knowledge of customer service concepts and techniques.
• Excellent organizational skills with the ability to accomplish multiple tasks.
• Excellent communication and interpersonal skills with the ability to communicate clearly in person and on the phone.
• Strong computer skills.
• Ability to read, understand and follow oral and written instructions.
• Ability to maintain confidentiality.
• Ability to work independently and as a team member with minimal direct supervision.
• Ability to maintain a professional manner even under stressful situations.

Additional Information
With a career at any of the MaineHealth locations across Maine and New Hampshire, you’ll be working with health care professionals that truly value the people around them – both within the walls of the organization and the communities that surround it.
We offer benefits that support an individual's needs for today and flexibility to plan for tomorrow – programs such as paid parental leave, a flexible work policy, student loan assistance, training and education, along with well-being resources for you and your family.

MaineHealth remains focused on investing in our care team and developing an inclusive environment where you can thrive and feel supported to realize your full potential. If you’re looking to build a career in a place where people help one another deliver best-in-class care, apply today.

Location: MaineHealth · MMP MH Cancer Care Sanford
Schedule: Full Time, Day Shift, 40