Primary responsibility is to obtain prior authorization from insurance companies for patients receiving chemotherapy. This includes electronically access insurance company website portals and/or contact via telephone or fax to request prior authorization. Ensuring appropriate ICD-10 codes are associated with the patients EMR prior to these prior authorization requests. Communicating with treatment team (nurses/doctors/manager) on prior authorization status. Appropriate documentation of denied/approval authorizations. Verifies patient demographic and insurance information in RCX and Cerner billing systems. Batches all IC10 and CPT's for outpatient billing documentation. Enters charge batches into RCX rules and Cerner billing systems in a timely fashion. Reconciles batch totals, logs and files completed batches. Denial management for all authorization rejected claims.
Qualifications
High School Diploma required. At least one year billing experience required with knowledge of CPT and ICD-10 coding, patient registration and third party insurances. Experience with RCX rules, Cerner Registration, iPAS, Cerner and RCX charge entry and payment posting functions preferred. Knowledge of Artiva Denial Management preferred. Knowledge of Chemotherapy drugs preferred.
Conditions of Employment
Covid Vaccination is a requirement for employment at Jefferson for employees working at Jefferson's clinical entities or at the University. If you are not currently vaccinated you will be required to receive the vaccination prior to hire date if you are offered employment, unless you request and receive an approved medical or religious exemption from Jefferson.
Closing Statement
Jefferson includes Thomas Jefferson University and Jefferson Health, a dynamic university and health system with broad reach across the Delaware Valley. Jefferson is the second largest employer in Philadelphia and the largest health system in Philadelphia based on total licensed beds.
Through the merger of Thomas Jefferson University and Philadelphia University in 2017, our University includes ten colleges and four schools. We are an NCAA Division II university and an R2 national doctoral university offering undergraduate and graduate-level programs that provide students with a forward-thinking education in architecture, business, design, engineering, fashion and textiles, health, medicine and social science.
Jefferson Health, the clinical arm of Thomas Jefferson University, has grown from a three-hospital academic health center in 2015, to an 18-hospital health system through mergers and combinations that include hospitals at Abington Health, Aria Health, Kennedy Health, Magee Rehabilitation and Einstein Healthcare Network. We have over 50 outpatient and urgent care centers; ten Magnet®-designated hospitals (recognized by the ANCC for nursing excellence); the NCI-designated Sidney Kimmel Cancer Center (one of only 70 in the country and one of only two in the region); and one of the largest faculty-based telehealth networks in the country. In 2021, Jefferson Health became the sole owner of HealthPartners Plan, a not-for-profit health maintenance organization in Southeastern Pennsylvania. We are the first health system regionally to create an aligned payer-provider partnership.
Jefferson's mission, vision and values create an organization that attracts the best and the brightest students, faculty, staff, and healthcare professionals, as well as the most visionary leaders to drive exceptional results.

• OUR MISSION: We improve lives.
• OUR VISION: Reimagining health, education and discovery to create unparalleled value
• OUR VALUES: Put People First, Be Bold & Think Differently and Do the Right Thing

As an employer, Jefferson maintains a commitment to provide equal access to employment. Jefferson values diversity and encourages applications from women, members of minority groups, LGBTQ individuals, disabled individuals, and veterans.