Title: Prior Authorization Specialist/Clinical Insurance Reviewer - Remote ( Southern Nevada only) Location: Nevada United States Job Description: Revenue Cycle Comprehensive Cancer Centers of Nevada 39944 Overview At Comprehensive Cancer Centers of Nevada (CCCN) a distinguished team of doctors, researchers, nurses and healthcare professionals have provided patients with groundbreaking treatments on the healing edge of medicine for over 50 years. Our team is dedicated to providing the most effective treatments, both existing and emerging, in order to diagnose and successfully treat cancer and blood disorders. We support this goal with state-of-the-art facilities across Southern Nevada, all of which integrate the latest diagnostic, therapeutic and research capabilities. CCCN is dedicated to patient-centered care, advancing innovation, discovery, and improving outcomes. Motivated, caring professional are encouraged to join us. Career Opportunity: Comprehensive Cancer Centers of Nevada is seeking a Clinical Insurance Reviewer to work remotely in the Southern Nevada area only. The Clinical Reviewer reviews diagnostic imaging and pulmonary testing orders in accordance to reimbursement guidelines and obtains necessary pre-certifications and exceptions to ensure no delay in reimbursement of treatments. Scope: Under general supervision, reviews chemotherapy regimens in accordance to reimbursement guidelines. Obtains necessary pre-certifications and exceptions to ensure no delay in reimbursement of treatments. Researches denied services and alternative resources to pay for treatment. Supports and adheres to the US Oncology Compliance Program, to include the Code of Ethics and Business Standards. Responsibilities ESSENTIAL DUTIES AND RESPONSIBILITIES: - Reviews, processes and audits the medical necessity for each patient radiation oncology treatment, imaging and testing requests - Communicates with nursing and medical staff to inform them of any restrictions or special requirements in accordance with particular insurance plans. Provides prompt feedback to physicians and management regarding documentation issues and payer issues with non-covered or denied services - Updates coding/payer guidelines for clinical staff - Obtains insurance authorization and pre-certification for imaging, pulmonology and surgical services; works as a patient advocate and functions as a liaison between the patient and payer to answer reimbursement questions and avoid insurance delays. - Researches additional or alternative resources for non-covered chemotherapy services to prevent payment denials. Provides a contact list for patients community resources including special programs, drugs and pharmaceutical supplies and financial resources. - Maintains a good working knowledge of authorization requirements for all payers, State and federal regulatory guidelines for coverage and authorization - Adheres to confidentiality, state, federal, and HIPPA laws and guidelines with regards to patient's records - Other duties as requested or assigned Qualifications MINIMUM QUALIFICATIONS: - High school diploma or equivalent required - Associates degree in Healthcare, LPN state license and registration preferred - Minimum three (3) years medical insurance verification and authorization required PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is required to be present at the employee site during regularly scheduled business hours and regularly required to sit or stand and talk or hear. Requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination. Requires standing and walking for extensive periods of time. Occasionally lifts and carries items weighing up to 40 lbs. Requires corrected vision and hearing to normal range. WORK ENVIRONMENT: The work environment may include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations and other conditions common to an oncology/hematology clinic environment. Work will involve in-person interaction with co-workers and management and/or clients. Work may require minimal travel by automobile to office sites. Successful candidates will thrive in a fast-paced, rapidly changing environment and have a passion for caring for their patients. Ready For Your Next Career Challenge? We’d Love to Hear from You! If you possess the above qualifications and a desire to make a difference, we invite you to submit your resume and apply. In addition to a great career opportunity, we offer excellent benefits, a team environment, professional development, and the chance to be part of a nationwide network dedicated to fighting the war against cancer. To apply please click on the “Apply” link. The US Oncology Network is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability, or protected veteran status. This employer participates in E-Verify.

• Manage policies throughout the full lifecycle: quote, bind, endorse, renew • Process endorsements, cancellations, and policy updates accurately and efficiently • Handle renewals and remarketing to ensure competitive coverage and pricing • Maintain precise and up-to-date records within the agency management system (AMS) • Client Communication via phone, email, and messaging • Clearly explain coverage options, policy terms, and premiums • Support clients with policy changes and service inquiries • Conduct multi-carrier quoting and coverage comparisons • Work directly with carriers to bind, amend, and renew policies • Navigate carrier portals and underwriting requirements effectively

- Assist brokers in preparing insurance quotes and processing new business, renewals, and endorsements. - Manage and organise all policy documentation, compliance records, and client correspondence. - Coordinate with insurers and underwriters to lodge and follow up on insurance claims. - Maintain accurate and up-to-date records within CRM and broking systems (e.g., Insight, WinBEAT, or similar). - Ensure all workflows, documentation, and audit trails align with industry and company standards. - Monitor compliance-related tasks to ensure adherence to regulatory requirements. - Support continuous process improvement initiatives to enhance efficiency and service delivery. - Provide responsive and professional support to both internal teams and clients. - Other role specific duties as they arise.

• Insurance Coordination and Accounts Receivable for multiple remote dental locations • Responsible for processing appeals to insurance companies • Processes all insurance billing, posting payments and claim estimates for multiple assigned dental practices • Coordinates and processes payments from insurance carriers and troubleshoots any issues related to these payments • Ensures coordination of benefits is accurate and considered as part of the financial planning • Serves as a liaison between insurance carriers, staff and patients to resolve any concerns and maintain a positive working relationship • Ensures all insurance related duties are completed in a timely and accurate manner to ensure excellent patient relations and financial success for multiple dental locations • Achieves revenue goals by effectively managing collections and receivables, specialty, insurance billing and all accounts receivables follow up • Processes all forms of insurance payments • Assists designated offices with appropriate payment and insurance processes • Responsible for accounts receivables to include, sending of billing statements, aging reports, and collections • Ensure proper fee schedules are paid out • Guidance from Senior Director of RCM & assigned insurance carriers • Responsible for running reports from reporting system (SageNet) for accuracy of collecting, processing outstanding aging claims • Other duties as required • Recognize and report discrepancies to Supervisors and Management • Communicate with customers via phone and email to help gather missing details and support documentation