Current jobs related to Advance Authorization Specialist- AH LC Cancer and Blood - CHARLOTTE - Atrium Health
-
Charlotte, United States Atrium Health Full timeOverview Primary Purpose The Advanced Authorization Specialist is responsible for all aspects involved in obtaining highly complex authorizations for a multitude of In-patient and Out-patient Services. The Advanced Authorization Specialist must be knowledgeable and have a thorough understanding of Commercial and Government payors with regards to...
-
CHARLOTTE, United States Atrium Health Full timeOverview Primary Purpose The Advanced Authorization Specialist is responsible for all aspects involved in obtaining highly complex authorizations for a multitude of In-patient and Out-patient Services. The Advanced Authorization Specialist must be knowledgeable and have a thorough understanding of Commercial and Government payors with regards to...
-
Charlotte, United States Atrium Health Full timeOverview Primary Purpose The Advanced Authorization Specialist is responsible for all aspects involved in obtaining highly complex authorizations for a multitude of In-patient and Out-patient Services. The Advanced Authorization Specialist must be knowledgeable and have a thorough understanding of Commercial and Government payors with regards to...
-
CHARLOTTE, United States Atrium Health Full timeOverview Primary Purpose The Advanced Authorization Specialist is responsible for all aspects involved in obtaining highly complex authorizations for a multitude of In-patient and Out-patient Services. The Advanced Authorization Specialist must be knowledgeable and have a thorough understanding of Commercial and Government payors with regards to...
-
CHARLOTTE , North Carolina ,, Mecklenburg County, NC, United States Atrium Health Full timeOverview Primary Purpose The Advanced Authorization Specialist is responsible for all aspects involved in obtaining highly complex authorizations for a multitude of In-patient and Out-patient Services. The Advanced Authorization Specialist must be knowledgeable and have a thorough understanding of Commercial and Government payors with regards to...
-
Charlotte, NC, United States Atrium Health Full timeOverview Primary Purpose The Advanced Authorization Specialist is responsible for all aspects involved in obtaining highly complex authorizations for a multitude of In-patient and Out-patient Services. The Advanced Authorization Specialist must be knowledgeable and have a thorough understanding of Commercial and Government payors with regards to...
-
Charlotte, NC, United States Atrium Health Full timeOverview Primary Purpose The Advanced Authorization Specialist is responsible for all aspects involved in obtaining highly complex authorizations for a multitude of In-patient and Out-patient Services. The Advanced Authorization Specialist must be knowledgeable and have a thorough understanding of Commercial and Government payors with regards to...
-
Charlotte, NC, United States Atrium Health Full timeOverview Primary Purpose The Advanced Authorization Specialist is responsible for all aspects involved in obtaining highly complex authorizations for a multitude of In-patient and Out-patient Services. The Advanced Authorization Specialist must be knowledgeable and have a thorough understanding of Commercial and Government payors with regards to...
-
Advance Authorization Specialist
3 weeks ago
charlotte, United States Atrium Health Full timeOverview Primary PurposeThe Advanced Authorization Specialist is responsible for all aspects involved in obtaining highly complex authorizations for a multitude of In-patient and Out-patient Services. The Advanced Authorization Specialist must be knowledgeable and have a thorough understanding of Commercial and Government payors with regards to...
-
Advance Authorization Specialist
2 days ago
Charlotte, United States Atrium Health Full timeOverview Primary Purpose The Advanced Authorization Specialist is responsible for all aspects involved in obtaining highly complex authorizations for a multitude of In-patient and Out-patient Services. The Advanced Authorization Specialist must be knowledgeable and have a thorough understanding of Commercial and Government payors with regards to...
-
Advance Authorization Specialist
2 weeks ago
CHARLOTTE, United States Atrium Health Full timeOverview Primary Purpose The Advanced Authorization Specialist is responsible for all aspects involved in obtaining highly complex authorizations for a multitude of In-patient and Out-patient Services. The Advanced Authorization Specialist must be knowledgeable and have a thorough understanding of Commercial and Government payors with regards to...
-
Advance Authorization Specialist
3 weeks ago
Charlotte, NC, United States Atrium Health Full timeOverview Primary Purpose The Advanced Authorization Specialist is responsible for all aspects involved in obtaining highly complex authorizations for a multitude of In-patient and Out-patient Services. The Advanced Authorization Specialist must be knowledgeable and have a thorough understanding of Commercial and Government payors with regards to...
-
Breast Cancer Specialist
3 weeks ago
Charlotte, North Carolina, United States Atrium Health Full timeTransforming Cancer Care in the CarolinasAtrium Health Levine Cancer is a pioneering institution dedicated to delivering exceptional cancer care across the Carolinas. Our comprehensive network of affiliated hospitals and providers enables us to provide unparalleled expertise in treating solid tumor and blood cancers.With a team of over 100 experienced cancer...
-
Blood Disorder Specialists
2 weeks ago
Charlotte, North Carolina, United States destinationone Consulting Full timeJob Title: Blood Disorder SpecialistsAt destinationone Consulting, we specialize in recruitment across diverse sectors, including Healthcare. We are proactively building a data bank for opportunities in these fields.Job Description: Hematologists specialize in blood disorders and conditions.Key Responsibilities:Diagnose and treat blood-related...
-
Charlotte, North Carolina, United States Atrium Health Full timeUnlock Your Potential as a Breast Cancer Physician at Atrium Health Levine CancerAtrium Health Levine Cancer is a pioneering institution dedicated to delivering exceptional cancer care across the Carolinas. We invite board-certified hematologist/oncologists to join our esteemed team of specialists in treating solid tumor and blood cancers.About the RoleWe...
-
Blood Drive Account Manager
3 weeks ago
Charlotte, North Carolina, United States The Blood Connection Full timeAccount Manager Job DescriptionThe Blood Connection is seeking a highly motivated and organized Account Manager to join our Donor Resources Department. As a key member of our team, you will be responsible for managing existing blood drive accounts, maximizing their production, and finding new accounts to work efficiently with corporate resources.Key...
-
Clinical Laboratory Technician
2 weeks ago
Port Charlotte, Florida, United States Florida Cancer Specialists Full timeJob SummaryAs a Clinical Laboratory Technician at Florida Cancer Specialists & Research Institute, you will play a vital role in ensuring the accuracy and reliability of laboratory testing results. Your expertise in quality control, phlebotomy, and instrument maintenance will be essential in supporting our medical team in providing world-class cancer...
-
Reiki Therapist
4 weeks ago
Charlotte, North Carolina, United States Atrium Health Full timeJob SummaryWe are seeking a skilled Reiki Therapist to join our team at Atrium Health, providing therapeutic massage to children with cancer and blood disorders.Key ResponsibilitiesPerform a variety of massage techniques under the guidance of leadership to restore function, prevent disability, and reduce stress.Conduct accurate clinical assessments and...
-
Charlotte, United States Atrium Health Full timeIf it’s possible, you will find it at Atrium Health —the third largest nonprofit healthcare system in the country. We invite Pediatric Hematologist to discover all that we can do when we bring healing hearts, inquisitive minds, and progressive visionaries together in our Levine Children’s Cancer & Blood Disorders Clinic. Levine...
-
Charlotte, United States Atrium Health Full timeIf it’s possible, you will find it at Atrium Health—the third largest nonprofit healthcare system in the country. We invite Pediatric Hematologist to discover all that we can do when we bring healing hearts, inquisitive minds, and progressive visionaries together in our Levine Children’s Cancer & Blood Disorders Clinic.Levine Children’s...
Advance Authorization Specialist- AH LC Cancer and Blood
2 months ago
Overview
Primary Purpose The Advanced Authorization Specialist is responsible for all aspects involved in obtaining highly complex authorizations for a multitude of In-patient and Out-patient Services. The Advanced Authorization Specialist must be knowledgeable and have a thorough understanding of Commercial and Government payors with regards to Coordination of Benefits, Authorization guidelines, Pharmacy and Medical Benefit variances, as well as Medical Necessity Policies. The Advanced Authorization Specialist is responsible for reading and interpreting various complex medical records to obtain authorizations for requested services and treatment plans. Communication with clinic staff, providers, Pharmacists, and insurance companies is essential to ensure completed peer reviews, relay updated medical and specialty drug policies, and appeals. They work closely with the Hospital and Provider Denial Management Teams to review monthly denials and assess opportunities for retro-active authorizations and determine root cause analysis. Major Responsibilities- Assess time sensitive Referral Work Queues to obtain highly complex authorizations including IP/OP Chemotherapy, Radiology, specifically related to Oncology treatment plans, IP/OP Surgeries, Molecular and Genetic Laboratory Testing, specialty related PT/OT and Speech Therapy, Psychiatry, Neuro/Psych Evaluations, and Rehab evaluations.
- Manage high volume Stat request mailbox for all oncology facilities for potential life altering, high-cost treatment and procedures within a short time frame. Expected treatment within 1-3 days.
- Interpret medical records to determine initial and disease progression to prove medical necessity for ordered services and complete on-line clinical requests for advanced authorization.
- Manage Atrium Health preferred drug list (chemotherapy/immunotherapy/supportive drugs) with payors and correlate changes with oncology pharmacy.
- Manage Atrium Health drug formulary changes with authorization updates with payors.
- Review laboratory panels for Bone Marrow Biopsies to authorize Molecular Lab Studies, diagnosis specific.
- Review and address monthly denials for Chemotherapy Drugs, Molecular Labs and surgeries with payors and Atrium Health Denial Management Teams (HBO/PBO).
Education
Bachelors Degree or 3 years of authorization experience required.
Work Experience
Bachelors Degree or 3 years of authorization experience required.Knowledge / Skills / Abilities
- General knowledge and background in CPT and HCPCS Coding.
- Must be proficient with medical terminology and be familiar with clinical considerations as these relate to oncology services.
- Excellent written and oral communication skills required.
- Microsoft Excel, Word, Epic experience preferred.
- Databases, hospital registration, billing and clinical systems preferred.
- Work requires typing, filing, use of telephone and sitting for prolonged periods of time.
- Should be able to bend and lift up to 10lbs.
DISCLAIMER
All responsibilities and requirements are subject to possible modification to reasonably accommodate individuals with disabilities.
This job description in no way states or implies that these are the only responsibilities to be performed by an employee occupying this job or position. Employees must follow any other job-related instructions and perform any other job-related duties requested by their leaders.
