Authorization - Medical

4 weeks ago

Gilbert, United States IRONWOOD PHYSICIANS,P.C. Full time

**Ironwood Cancer & Research Centers** has beautiful state-of-the-art integrated Cancer and Breast Centers, with locations strategically located throughout the Valley. Each one provides a superior cancer care environment with a full spectrum of cancer related services for patients. Our multi-disciplinary team approach includes surgical oncology, medical oncology, radiation oncology, diagnostic imaging services, social service support, nutritionist, integrative services, and genetic counseling.

**Mission Statement**: To serve the community by providing quality, comprehensive cancer care which respects the values and needs of each individual.

**Overview**:We are looking for a motivated, professional, and friendly individual to work as an Authorization Specialist **at our Central Business Office in Gilbert.** The Authorization Specialist will be responsible for obtaining authorization for all drugs administered in the clinics prior to treatment.

**Schedule**: Full-time, Monday through Friday day shift position.

**Essential Duties and Responsibilities**:

- Obtain authorization for all drugs administered in the office prior to treatment following established guidelines for each payer.
- Run/work schedules daily, maintaining 4 weeks out consistently.
- Run/work add-on schedules daily.
- Work QCL’s prior to due date; respond to STAT QCL’s within 10 minutes.
- Follow up on all pending authorization requests daily to ensure that authorization is received prior to treatment.
- Maintains communication with physicians, management, clinical staff, financial counselors and insurance team regarding authorization concerns, treatment and patient benefits daily or as needed.
- Update authorization as needed when insurance plans change and/or authorization expires.
- Load authorizations into face sheet.
- Document detailed patient account notes and QCL comments.
- Send Authorizations to medical records for scanning daily.
- Answering incoming calls.
- Check monthly for any drug policy updates with all insurance payers.

**Knowledge and Skills**:

- Understanding of insurance verification process and how to read patient ledgers.
- Knowledge of Medical Office operations.
- Knowledge of medical terminology.
- Knowledge of CPT, ICD-10, HCPCS coding.
- Proficiency in basic mathematics.
- Proficiency in Microsoft Office, Word, Outlook, and Internet.
- Able to be in a seated position, talk on the phone, repetitive keyboard usage and clarity of vision at 20 inches or less.

**Education and Experience**:

- 1-3 years’ experience working in a medical office.
- High school diploma or equivalent required.
- Medical and Radiation Oncology experience preferred.
- We offer a competitive salary and a comprehensive benefit package including health/dental/vision and life insurance, 401K, and a caring work environment. We are an E.O.E._

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