Comprehensive Cancer Centers of Nevada (CCCN) is seeking a remote Insurance Prior Authorization Specialist for Southern Nevada only.
In this role, you will review chemotherapy regimens in accordance with reimbursement guidelines, obtain necessary pre-certifications and exceptions, and help prevent delays in patient treatment and reimbursement. You will also research denied services, alternative resources, and payer requirements while supporting compliance with company, state, federal, and HIPAA standards.
The position involves working with clinical and business office staff, payer portals, EMR systems, and community resources to support patients receiving oncology care.
Minimum qualifications
- High school diploma or equivalent
- Associate degree in Healthcare preferred
- LPN state license and registration preferred
- Minimum 3 years of medical insurance verification and authorization experience
Key skills and responsibilities
- Review and audit medical necessity for chemotherapy treatment documentation
- Obtain insurance authorizations and pre-certifications for chemotherapy services
- Communicate payer restrictions and special requirements to nursing and medical staff
- Use EMR systems, payer portals, and third-party web portals to submit authorizations
- Research alternative resources for non-covered services
- Maintain knowledge of chemotherapy authorization requirements, payer guidelines, and regulatory standards
- Follow confidentiality, HIPAA, state, and federal requirements
Benefits and perks
- Excellent benefits
- Team-oriented environment
- Professional development opportunities
Location
Henderson, Nevada, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
Yes
Posted
1 month ago