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Overview
Are you looking for a career and not just a job in the Medical field? Virginia Cancer Specialists, an affiliate of McKesson Specialty Health and US Oncology, a leader in Cancer care, is seeking a Full Time Chemo Authorization Specialist for our Aministrative Office.
SCOPE : Under general supervision verifies insurance eligibility, benefits, verification, prior authorization and researches denied services to ensure payments are processed on a timely basis.
Acts as a liaison to ensure accurate processing of all claims. 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 chemotherapy treatment and documentation of regimen and pathway adherence.
Works as a patient advocate and functions as a liaison between the patient and payer to answer reimbursement questions and avoid insurance delays.
Obtains insurance authorization and pre-certification for chemotherapy services. Researches additional or alternative resources for non-covered services to prevent payment denials.
Provides a contact list for patients community resources including special programs, drugs and pharmaceutical supplies and financial resources.
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 pathway documentation issues, and payer issues with non-covered chemotherapy drugs.
Prepares and submits write-off requests with appropriate documentation. -Processes insurance / patient correspondence, including denial follow-up.
Maintains reimbursement correspondence and filing systems. Reviews and processes adjustments and refund requests. Assists with review of financial disclosures and negotiated agreement adjustments.
Complies with patient confidentiality laws and regulations. -Updates coding / payer guidelines for clinical staff. Tracks pathways and performs various other business office functions on an as needed basis.
Qualifications MINIMUM QUALIFICATIONS : High school degree or equivalent. Associates degree in Healthcare
LPN state license and registration preferred. Minimum two (2) years medical insurance verification and authorization required.
Billing and coding experience preferred. 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 regularly required to sit and use hands to finger, handle, or feel.
The employee is occasionally required to stand, walk, and reach with hands and arms. The employee must occasionally lift and / or move up to 30 pounds.
Requires vision and hearing corrected to normal ranges. WORK ENVIRONMENT : The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Work is performed in an office environment and involves frequent interaction with patients, clinical and business office staff and payers.
Join us at Virginia Cancer Specialists, APPLY NOW! The US Oncology Network is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin.
Last updated : 2024-04-24
Full Time
$97k-119k (estimate)
04/25/2024
07/23/2024
The job skills required for Authorization specialist include Confidentiality, Prior Authorization, etc. Having related job skills and expertise will give you an advantage when applying to be an Authorization specialist. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Authorization specialist. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Authorization specialist positions, which can be used as a reference in future career path planning. As an Authorization specialist, it can be promoted into senior positions as a Medical Policy Manager that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Authorization specialist. You can explore the career advancement for an Authorization specialist below and select your interested title to get hiring information.
If you are interested in becoming an Authorization Specialist, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become an Authorization Specialist for your reference.
Step 1: Understand the job description and responsibilities of an Accountant.
Quotes from people on Authorization Specialist job description and responsibilities
Updates patient insurance and demographics information as needed.
03/31/2022: Florence, SC
Request, follow up and secure prior-authorizations prior to services being performed.
03/30/2022: Rochester, NY
Complete authorizations and referrals for services, including appointments and procedures.
01/29/2022: Clarksville, TN
Monitors incoming patient orders and gathers information needed to complete the pre-authorization and scheduling of an order
03/22/2022: Ann Arbor, MI
Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed
01/29/2022: York, PA
Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.
Career tips from people on Authorization Specialist jobs
There are great benefits to having a Prior Authorization Certified Specialist on staff to help with the administrative process.
03/31/2022: Greensboro, NC
Give credence to customer complaints.
02/08/2022: Salem, OR
Create a quick reference guide of your payor contacts
04/11/2022: Cincinnati, OH
Authorization Specialist assist with other clerical tasks as needed.
01/22/2022: Lincoln, NE
Licenses and certifications are not usually required to work as a prior authorization specialist.
03/09/2022: Bremerton, WA
Step 3: View the best colleges and universities for Authorization Specialist.