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Patient Coverage Specialist
2 months ago
Employment Type: Administrative
Position Type: Full Time
Make a meaningful impact in the lives of oncology patients by joining our dedicated team of healthcare professionals.
About Oncology Consultants
Oncology Consultants has established itself as a leading adult medical oncology and hematology practice, serving the community for over 40 years. Our team is devoted to delivering advanced cancer care in a compassionate setting as we expand our oncology services across the region.
Position Overview
The Authorization Specialist plays a crucial role in verifying insurance benefits and coverage to ensure that medical services and procedures are authorized by the patient's insurance provider. Upon confirming coverage, the specialist submits authorization requests through various channels, including insurance portals. Once authorization is obtained, the specialist is responsible for calculating the patient's financial obligations and discussing these details with the patient prior to any services or procedures being performed. Daily interactions with front office staff, clinical teams, and insurance representatives are essential for coordinating patient insurance information and completing the authorization process.
Work Schedule:
- Monday - Friday: 8 AM - 5 PM
- Monday - Friday: 9 AM - 6 PM
- Comprehensive insurance options: Life, medical, dental, short-term and long-term disability
- 401K plan
- Complimentary parking
- Paid time off (PTO)
- Holiday pay
- Competitive salary
- Employee Assistance Program
- Pet insurance
- Floating holidays
- Review upcoming schedules to identify patients requiring authorizations
- Utilize ONCO EMR to access the task list for requested authorizations
- Regularly check the task list throughout the day
- Verify insurance benefits and submit authorization requests in accordance with physician orders
- Engage directly with insurance companies to confirm coverage for ordered services and procedures
- Upon receiving authorization:
- Conduct financial assessments
- Determine the patient's out-of-pocket expenses
- Communicate with the patient regarding their financial responsibilities
- Provide financial assistance options if necessary
- Coordinate with nursing staff for scheduling post-authorization
- Document approval and authorization numbers in the patient's records
- Maintain clear and timely communication with patients and colleagues via company email
- Interact professionally with patients, physicians, and team members
- Collaborate with colleagues to achieve departmental objectives
- Adapt to changes and incorporate new ideas into daily tasks
- Deliver timely and accurate service to both patients and staff
- Comply with company policies and procedures
- Recognize priorities and act accordingly; optimize time management
- Proactively resolve issues to ensure smooth patient care flow
- Perform other duties as assigned by supervisors or management
- Minimum of 2 years of experience in insurance verification and authorization
- Experience in oncology preferred
- High school diploma or equivalent required
Preferred Skills:
- Bilingual in Spanish
- Typing speed of at least 35 words per minute
- Familiarity with business office procedures
- Experience with health insurance operations
- Proficient in using computers and standard office equipment
- Ability to manage a multi-line phone system
- Strong customer service skills
- Ability to follow oral and written instructions in English
- Excellent organizational and detail-oriented skills
Standard office environment. Requires sitting and standing typical of an office setting. Manual dexterity is necessary for operating a calculator and computer keyboard. This description serves as a basic guideline for fulfilling job requirements. Responsibilities, skills, and working conditions may evolve as needs change. Ability to read and comprehend simple instructions, short correspondence, and memos in English is essential. Occasional overtime may be required.
Language Skills: Proficiency in reading and understanding simple instructions, short correspondence, and memos in English. Ability to write simple correspondence. Occasional overtime may be required.
Comments:
This description outlines the essential job functions, general supplemental functions, and fundamental requirements for this position. It is not an exhaustive list of all duties, responsibilities, and requirements. Additional functions may be assigned, and management retains the right to modify duties as necessary.
Oncology Consultants maintains a drug-free workplace. Candidates must pass a drug test prior to employment.
