Top 212 Program support representative Jobs in Lincoln, Ne

Prior Authorization Specialist
Nebraska Hematology-Oncology —Lincoln, NE
- Customer service
- Medical office experience
- HIPAA
9d
SquareOne Navigator
Family Service Lincoln —Lincoln, NE
- $16 an hour
- Part-time
- HIPAA
- Research
- Driver's License
- Employee assistance program
- Gym membership
Quick Apply
Veterans Independence Program (VIP) Advisor
Center for People With Disabilities (CPWD) —Lincoln, NE
- $28 - $30 an hour
- Email
- Hybrid work
- Background check
- Spanish
- Clean driving record
- Paid holidays
- Health insurance
Quick Apply
2d
Concessions Attd, PT
Marcus Theatres South Pointe Cinema —Lincoln, NE
- Part-time
- Quick service & fast food restaurant
- Communication skills
- Entry level
EBT Program Specialist
State of Nebraska —Lincoln, NE
- $24.86 an hour
- Full-time
- Mid-level
- Office
- Driver's License
- Paid time off
8d
Customer Service Representative
Border States Industries, Inc. —Lincoln, NE
- Microsoft Excel
- Inventory management
- Computer literacy
- Health savings account
- Paid holidays
Management Trainee Program
Buckle —Lincoln, NE
- Weekends as needed
- Inventory management
- Ability to lift 50 pounds
- Bachelor's degree
- Paid time off
- Employee assistance program
NSO Apprentice Interest
Disabled American Veterans —Lincoln, NE
- $20.18 - $31.39 an hour
- Full-time
- Customer service
- Office
- High school diploma or GED
- On-the-job training
Quick Apply
Front Desk
TownePlace Lincoln —Lincoln, NE
- Part-time
- Computer literacy
- Basic math
- Hotel
Radiation Therapist - Full Time, Part Time, or PRN!
Nebraska Hematology-Oncology —Lincoln, NE
- Part-time
- Background check
- Computer literacy
- Mid-level
- Health savings account
- Health insurance
Quick Apply
State Growth Consultant
FBL Financial Group, Inc. —Lincoln, NE
- Full-time
- Hybrid work
- Marketing
- Driver's License
- Travel
- Paid holidays
- Disability insurance
11d
Electrician & Facilities Technician
Lincoln Airport Authority —Lincoln, NE
- $31.65 - $47.48 an hour
- Full-time
- 18 years or older
- Computer literacy
- Writing skills
Production Manager - Chemical Manufacturing Industry
E Energy Adams LLC - located 40 miles south of Lincoln, NE —Lincoln, NE
- Full-time
- Bachelor of Science
- English
- 3 years
- Health insurance
- Dental insurance
Quick Apply
CDL A Owner Operator - OTR
ICD Freight Inc —Lincoln, NE
- $1.73 per mile
- Online Application
- Owner-operator
- CDL A
- Mid-level
- Passenger ride along program
- Fuel card
Quick Apply
3d
Flight Nurse
Air Methods —Crete, NE
- $31.15 - $38.07 an hour
- Overtime
- CPR Certification
- Nursing
- Microsoft Excel
- AD&D insurance
- Disability insurance
Route Sales Representative
Hawkins Inc —Roca, NE
- $60,000 - $70,000 a year
- Call employer
- Computer literacy
- Basic math
- DOT physical examination
- Paid training
- Employee stock purchase plan
Quick Apply
4d
Financial Representative - Seeking Growth
Erickson Region - Modern Woodmen of America —Lincoln, NE
- $97,000 - $192,000 a year
- Full-time
- Hybrid work
- Management
- Children
- Recruiting
- Health insurance
- Dental insurance
Quick Apply
5d
Flight Paramedic
Air Methods —Crete, NE
- $25.54 - $31.22 an hour
- Overtime
- CPR Certification
- Microsoft Excel
- Microsoft Outlook
- AD&D insurance
- Disability insurance
Warehouse Office Clerk
Southshore Enterprises, Inc. —Seward, NE
- From $19 an hour
- Overtime
- Bilingual
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Dental insurance
Quick Apply
Entry Level Insurance Sales Agent
Performance Matters Associates —Lincoln, NE
- $60,000 - $80,000 a year
- Full-time
- No experience needed
- High school diploma or GED
- Driver's License
- Health insurance
- Opportunities for advancement
Quick Apply

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program support representative jobs near lincoln, ne

Prior Authorization Specialist

Nebraska Hematology-Oncology -
Lincoln, NE

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Job Details

9 days ago

Qualifications

HIPAA compliance
Defect resolution root cause analysis
Electronic health records (EHR) management
Customer service
HIPAA
High school diploma or GED
Medical treatment knowledge
Healthcare privacy protection
Data entry
Insurance policy review
Productivity software
Root cause analysis
Medical terminology

Full Job Description

JOB TITLE: Prior Authorization Specialist

JOB SUMMARY:

The Prior Authorization Specialist is responsible for obtaining, tracking, and documenting insurance authorizations for medical services, procedures, medications, and treatments. This position works closely with providers, clinical staff, patients, insurance companies, billing, and revenue cycle teams to ensure timely approvals, minimize delays in patient care, prevent authorization-related denials, and support positive patient and financial outcomes. This role is also responsible for proactively verifying payer-specific requirements, monitoring authorization expirations, and ensuring authorizations accurately reflect ordered treatment regimens, drug dosages, frequencies, diagnosis codes, treatment dates, and approved services.

REPORTS TO: Director of Patient Financial Services

PRINCIPAL DUTIES

Submit prior authorization requests to insurance companies through payer portals, phone calls, fax, or electronic submission systems.

Review treatment plans and verify payer-specific requirements prior to treatment initiation to ensure compliance with authorization, medical necessity, drug, diagnosis, and site-of-care requirements.

Verify insurance benefits and determine authorization requirements for scheduled services, treatments, procedures, medications, treatment changes, dose modifications, additional cycles, and supportive care services.

Ensure authorizations accurately reflect ordered treatment regimens, drug dosages, frequencies, diagnosis codes, units, treatment dates, and approved services.

Track authorization requests and follow up with insurance carriers to obtain timely determinations.

Monitor authorization expiration dates and proactively obtain extensions or renewals to prevent treatment delays and claim denials.

Document authorization approvals, denials, pending requests, payer communications, approval numbers, effective dates, units, drug details, and related information accurately within the electronic medical record and billing systems.

Coordinate with providers, nursing, and clinical staff to obtain medical records, clinical documentation, treatment details, and supporting information required for authorization requests and medical necessity reviews.

Identify authorization requests requiring clinical review, peer-to-peer discussion, or provider input and escalate timely to the appropriate clinical team member.

Communicate authorization status updates to patients, providers, clinical staff, and other departments as appropriate.

Review denied authorization requests and assist with gathering documentation needed for reconsiderations, appeals, or additional payer review.

Maintain current knowledge of payer-specific authorization requirements, medical necessity guidelines, medical policies, covered services, specialty drug authorization requirements, and site-of-care requirements.

Maintain payer-specific authorization reference materials and communicate updates to impacted departments.

Identify and communicate potential authorization delays that may impact patient care or reimbursement.

Collaborate with Revenue Cycle, Billing, Clinical Operations and other internal departments to identify and resolve authorization-related denial trends and root causes.

Support revenue cycle and billing functions by ensuring required authorizations are obtained, accurate, and documented appropriately prior to services being billed.

Maintain compliance with organizational policies, payer requirements, HIPAA regulations, and applicable state and federal regulations.

Participate in departmental meetings, training programs, and process improvement initiatives.

Perform other duties as assigned.

PERFORMANCE REQUIREMENTS

Strong organizational skills with the ability to manage multiple priorities and deadlines.

Excellent communication and customer service skills.

Ability to work independently while maintaining accuracy and attention to detail.

Strong critical thinking, problem-solving, and root-cause analysis skills.

Ability to interpret insurance policies, payer medical policies, authorization requirements, medical necessity criteria, and specialty drug authorization requirements.

Ability to analyze authorization and denial trends and identify opportunities to prevent recurring authorization-related denials.

Ability to prioritize work based on treatment schedules, authorization turnaround times, patient access needs, and financial impact.

Demonstrated ability to manage high-volume workloads while maintaining accuracy and timeliness.

Working knowledge of medical terminology, healthcare procedures, oncology treatment regimens, infusion services, specialty medications, and insurance processes.

Strong understanding of authorization requirements for infusion, oncology, and supportive care services preferred.

Proficiency with electronic medical records, insurance portals, payer systems, and Microsoft Office applications.

Ability to maintain confidentiality and comply with HIPAA regulations.

Ability to work effectively with patients, providers, clinical staff, billing, revenue cycle, and insurance representatives.

Ability to accurately document and communicate authorization outcomes.

TYPICAL PHYSICAL DEMANDS

Requires full range of motion, including manual dexterity and eye-hand coordination for computer use, data entry, and document handling.

Frequent sitting with occasional standing and walking throughout the workday.

Occasionally lifts and carries items weighing up to 25 pounds.

Requires corrected vision and hearing to a normal range for effective communication and review of documentation.

Ability to work under pressure and meet deadlines in a high-volume environment.

TYPICAL WORKING CONDITIONS

Work is primarily performed in an office environment with extensive computer use.

Frequent interaction with patients, providers, clinical staff, and insurance representatives.

Regular communication regarding authorization approvals, denials, and treatment scheduling needs.

May occasionally encounter frustrated patients or payer representatives related to authorization decisions or delays.

EDUCATION

High school diploma or GED required.

Associate degree in healthcare administration, business, or a related field preferred.

EXPERIENCE

Minimum of two (2) years of experience in a healthcare, medical office, insurance, or revenue cycle environment preferred.

Prior authorization, insurance verification, medical billing, or related healthcare experience preferred.

Experience working with electronic medical records and payer portals preferred.

Knowledge of Oncology treatment, regimens, infusion services, and specialty medications preferred.

Experience obtaining authorizations for chemotherapy, immunotherapy, supportive care drugs, specialty medications, and advanced imaging preferred.

Experience working with Medicare, Medicare Advantage, Medicaid, and commercial payer authorization processes preferred.

Clinical background, coding knowledge, or experience working directly with oncology treatment regimens preferred.

POSITION SUMMARY

The Prior Authorization Specialist plays an important role in supporting patient access to care by ensuring timely and accurate authorization processing, maintaining compliance with payer requirements, preventing authorization-related denials, and supporting efficient revenue cycle operations. This position requires strong attention to detail, proactive follow-up, effective communication with clinical and revenue cycle teams, and the ability to manage payer requirements in a high-volume oncology environment.

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Refine Your Search

program support representative jobs in lincoln, ne

Prior Authorization Specialist

SquareOne Navigator

Veterans Independence Program (VIP) Advisor

Concessions Attd, PT

EBT Program Specialist

Customer Service Representative

Management Trainee Program

NSO Apprentice Interest

Front Desk

Radiation Therapist - Full Time, Part Time, or PRN!

State Growth Consultant

Electrician & Facilities Technician

Production Manager - Chemical Manufacturing Industry

CDL A Owner Operator - OTR

Flight Nurse

Route Sales Representative

Financial Representative - Seeking Growth

Flight Paramedic

Warehouse Office Clerk

Entry Level Insurance Sales Agent

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