Prior Authorization Nurse Specialist

Central Care Cancer Center is hiring a Prior Authorization Nurse Specialist to join their billing team in Salina, KS. This position is expected to work in the Salina Administrative Office 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