What are the responsibilities and job description for the Radiation Oncology PreCertification Specialist position at The Center for Cancer and Blood Disorders?
JOB DESCRIPTION:
We want you to join our team! The Center for Cancer and Blood Disorders has more than 60 cancer specialists and 400 healthcare professionals representing many different areas of medical and administrative services across 22 locations in North Texas. We can offer you a competitive salary and a complete benefits package. All full time employees are eligible for an annual profit sharing bonus. Health benefits begin on day 1 of employment. The Radiation Oncology Insurance Precertification Specialist is responsible for obtaining prior authorizations for all treatment orders by successfully completing the authorization process with all payers.
RESPONSIBILITIES
- Review chart documentation to ensure patient meets medical policy guidelines
- Prioritize incoming authorization requests according to urgency
- Obtain authorization via payer website or by phone and follow up regularly on pending cases
- Maintain individual payer files to include up to date requirements needed to successfully obtain authorizations
- Initiate appeals for denied authorizations
- Respond to clinic questions regarding payer medical policy guidelines
- Confirm accuracy of CPT and ICD-10 diagnoses in the procedure order
- Contact patients to discuss authorization status
- Other duties as assigned
KNOWLEDGE, SKILLS, AND ABILITIES
- Knowledge of procedure authorization and its direct impact on the practice’s revenue cycle
- Understanding of payer medical policy guidelines while utilizing these guidelines to manage authorizations effectively
- Basic understanding of human anatomy, specifically musculoskeletal
- Proficient use of CPT and ICD-10 codes
- Familiar with CoverMyMeds
- Excellent computer skills including Excel, Word, and Internet use
- Detail oriented with above average organizational skills
- Plans and prioritizes to meet deadlines
- Excellent customer service skills; communicates clearly and effectively
- Ability to multitask and remain focused while managing a high-volume, time-sensitive workload
Salary determined by experience and skill set
Job Type: Full-time
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Disability insurance
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
Experience:
- Medical billing: 1 year (Preferred)
- Insurance PreCertification: 1 year (Required)
Work Location: In person
Salary : $55,263 - $81,330