Category:
Admin Support
City:
Jackson
State:
Tennessee
Shift:
0 - Day (United States of America)
Job Description Summary:
Under the general direction of the Kirkland Cancer Center Business Manager, this employee is responsible for obtaining, tracking and updating authorizations for all visits and treatment provided for KCC medical oncology clinic patients. This individual assists with coverage for other clerical staff for vacations and/or days off. Employee is subject to call back and overtime as required by the hospital.
ESSENTIAL JOB FUNCTIONS :

• Responsible for obtaining and documenting in Aria and AS400/Series all Pre-Authorizations for clinic treatments and visits.
• Develops reports from Aria in order to monitor and track authorizations due for renewal
• Manages all incoming communications and correspondence from third party payors.
• Responsible for assisting with faxes and entering precertification information in AS400 and Aria, and relaying the information to the appropriate staff member.
• Works appeals, denials and completes retro review requests.
• Identifies any billing issues and works to correct any issues that inhibit the collection process.
• Responsible for notifying Admissions with any updates regarding guarantor/patient demographic or insurance information.
• Scans all authorization correspondence into Aria according to set standards and maintains records in a confidential manner.
• Understands Current Procedural Terminology and its relationship with ICD-9 (ICD-10) diagnosis coding to assist with pre-certifications. Needs to be able to reference both manuals as a resource and know how to research issues when necessary.
• Must be able to back up other clinic business office functions including reception, greeting patients, scheduling, answering phone calls and other office functions as needed, as well as providing coverage for vacation and/or days off.
• Performs related responsibilities as required or directed.

JOB SPECIFICATIONS
EDUCATION:

• High school graduate with a minimum of two (2) years of business related education preferred.

LICENSURE, REGISTRATION, CERTIFICATION:

• None required

• Prefer prior experience in a clinic office setting obtaining insurance authorizations for services.

• Three to five years of business or medical related customer service experience.

EXPERIENCE:

• Prefer prior experience in a clinic office setting obtaining insurance authorizations for services.
• Three to five years of business or medical related customer service experience.

NONDISCRIMINATION NOTICE STATEMENT
We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, disability, religion, national origin, gender, gender identity, gender expression, marital status, sexual orientation, age, protected veteran status, or any other characteristic protected by law.