Insurance Authorization Specialist
2 days ago
We are seeking a highly skilled Insurance Authorization Specialist to join our team at Texas Oncology. This full-time remote position will support our Longview clinic and will be responsible for ensuring seamless insurance authorization and reimbursement processes for our patients.
Key Responsibilities- Review and process medical necessity for each patient's chemotherapy treatment and documentation of regimen relative to pathway adherence.
- Communicate with nursing and medical staff to inform them of any restrictions or special requirements in accordance with particular insurance plans.
- Provide prompt feedback to physicians and management regarding pathway documentation issues and payer issues with non-covered chemotherapy drugs.
- Update coding/payer guidelines for clinical staff and track pathways as needed.
- Obtain insurance authorization and pre-certification specifically for chemotherapy services.
- Work as a patient advocate and function as a liaison between the patient and payer to answer reimbursement questions and avoid insurance delays.
- Research additional or alternative resources for non-covered chemotherapy services to prevent payment denials.
- Maintain a good working knowledge of chemotherapy authorization requirements for all payers, State and federal regulatory guidelines for coverage and authorization.
- High school degree or equivalent.
- Associates degree in Healthcare, LPN state license and registration preferred.
- Minimum three (3) years medical insurance verification and authorization experience.
- Level Sr: Minimum three (3) years medical insurance verification and authorization and two (2) years clinical review experience required.
- Uses Technical and Functional Experience: Possesses up to date knowledge of the profession and industry.
- Demonstrates Adaptability: Handles day to day work challenges confidently.
- Uses Sound Judgment: Makes timely, cost effective and sound decisions.
- Shows Work Commitment: Sets high standards of performance.
- Commits to Quality: Emphasizes the need to deliver quality products and/or services.
-
Insurance Authorization Coordinator
10 hours ago
Dallas, Texas, United States KidsCare Home Health Full timeAbout the RoleKidsCare Home Health is seeking a highly skilled Insurance Authorization Specialist to join our team. As an award-winning organization, we are committed to delivering exceptional care to our patients and their families.Key ResponsibilitiesMaintain authorization workflows to obtain routine, initial, and reauthorizations.Schedule authorized...
-
Insurance Authorization Coordinator
2 weeks ago
Richardson, Texas, United States Texas Oncology Full timePosition Overview:Texas Oncology is seeking an Insurance Authorization Coordinator to enhance our Central Business Office operations. This full-time remote role is essential in facilitating the authorization process for chemotherapy treatments, ensuring seamless reimbursement procedures.Key Responsibilities:The primary duties include but are not limited to:-...
-
Insurance Eligibility Specialist
3 weeks ago
Longview, Texas, United States Christus Health Full timeOverview:This role is responsible for conducting insurance eligibility checks for both scheduled and unscheduled patients. The specialist will engage with insurance providers and utilize our electronic eligibility verification system. Additionally, this position involves analyzing eligibility data to estimate the patient's financial responsibility based on...
-
Insurance Eligibility Specialist
2 weeks ago
Longview, Texas, United States Christus Health Full timeOverview:This role is responsible for conducting insurance eligibility checks for both scheduled and unscheduled patients. The specialist will engage with insurance providers and utilize our electronic eligibility platform to ensure accurate verification. Additionally, this position involves analyzing eligibility data to estimate the patient's financial...
-
Authorization Specialist
2 days ago
Dallas, Texas, United States Enhabit Home Health & Hospice Full timeAbout the RoleWe are seeking a highly organized and detail-oriented Authorization Coordinator to join our team at Enhabit Home Health & Hospice. As an Authorization Coordinator, you will play a critical role in ensuring that our patients receive the necessary authorizations for their care.Key ResponsibilitiesProvide accurate and complete data input for...
-
Insurance Verification Specialist
2 weeks ago
Longview, Texas, United States Christus Health Full timeJob Summary:This position provides critical insurance verification functions for all scheduled and unscheduled patients at Christus Health. The Insurance Verification Specialist will contact insurance companies, utilize our electronic eligibility system, and analyze eligibility information to provide accurate estimates of patients' portions based on their...
-
Personal Lines Insurance Account Specialist
3 weeks ago
Dallas, Texas, United States C1 Insurance Group Full timePersonal Lines Insurance Account SpecialistPosition Type: Full-Time, In-OfficeCompany Overview:C1 Insurance Group is a dynamic insurance agency located in Dallas, fostering a vibrant and supportive workplace culture. We pride ourselves on being a growing team that values a family-oriented atmosphere, working collaboratively to deliver exceptional service to...
-
Insurance Billing Specialist
6 hours ago
Longview, Washington, United States Gentle Dental Full timeAt Gentle Dental, we're seeking a skilled Insurance Billing Specialist to join our team. As a key member of our insurance billing team, you'll be responsible for managing claims and working closely with DentiCal insurance. Your expertise will ensure seamless billing processes, allowing our patients to focus on their health and well-being.**Benefits of...
-
Personal Lines Insurance Service Specialist
2 weeks ago
Longview, Texas, United States Gans & Smith Insurance Agency Full timeJob OverviewThe Personal Lines Customer Service Representative at Gans & Smith Insurance Agency plays a crucial role in fostering strong customer relationships. This position involves addressing customer inquiries and concerns with efficiency and professionalism through daily interactions with clients, insurance providers, and colleagues while executing...
-
Personal Lines Insurance Service Specialist
2 weeks ago
Longview, Texas, United States Gans & Smith Insurance Agency Full timeJob OverviewThe Personal Lines Customer Service Representative at Gans & Smith Insurance Agency plays a crucial role in fostering strong customer relationships. This position involves addressing customer inquiries and concerns with efficiency and professionalism through daily interactions with clients, insurance providers, and colleagues while executing...
-
Personal Lines Insurance Service Specialist
2 weeks ago
Longview, Texas, United States Gans & Smith Insurance Agency Full timeJob OverviewThe Personal Lines Customer Service Representative at Gans & Smith Insurance Agency plays a crucial role in fostering strong client relationships by efficiently addressing customer inquiries and concerns. This position involves daily interactions with clients, insurance providers, and team members while executing specific service and marketing...
-
Insurance Eligibility Specialist
2 weeks ago
Longview, Texas, United States Christus Health Full timeOverview:The Insurance Verification Clerk plays a crucial role in ensuring that all scheduled and unscheduled patients have their insurance eligibility confirmed. This involves direct communication with insurance providers and the use of our advanced electronic eligibility systems. The position also entails analyzing eligibility data to estimate patient...
-
Insurance Eligibility Specialist
2 weeks ago
Longview, Texas, United States Christus Health Full timeOverview:This role is responsible for conducting insurance verification processes for both scheduled and unscheduled patients by engaging with insurance providers and utilizing our electronic eligibility platform. The position involves analyzing eligibility data and providing estimates of the patient's financial responsibility based on their insurance...
-
Prior Authorization Specialist
13 hours ago
Frisco, Texas, United States Baylor Scott & White Institute for Rehabilitation - Frisco Hospital Full timeJob SummaryBaylor Scott & White Institute for Rehabilitation - Frisco Hospital is seeking a skilled Prior Authorization Specialist to join our team. As a Prior Authorization Specialist, you will play a critical role in managing the pre-certification and prior authorization of referrals scheduled for admission to our Acute Inpatient Rehabilitation...
-
Insurance Underwriting Support Specialist
3 weeks ago
Dallas, Texas, United States NSM Insurance Group, LLC Full timePosition Overview:NSM Insurance Group, LLC is a leading provider of insurance solutions tailored for the commercial towing and garage sector, proudly serving agents for over three decades. Our organization offers a comprehensive suite of affordable coverage options, supported by an A+ rated insurance carrier. We are recognized for our expertise and...
-
Cancer Treatment Authorization Coordinator
2 weeks ago
Austin, Texas, United States Texas Oncology Full timePosition Overview:Texas Oncology is seeking a dedicated Cancer Treatment Authorization Coordinator to become a vital part of our team. This remote role will contribute to our Central Texas Regional Business Office, ensuring seamless insurance authorization processes for chemotherapy treatments.As a member of The US Oncology Network, Texas Oncology is...
-
Clinical Review Nurse for Prior Authorization
2 weeks ago
Texas, United States Pyramid Consulting, Inc Full timeWe are currently seeking a skilled Clinical Review Nurse for Prior Authorization. This position offers a contract opportunity with the potential for long-term engagement and is available for remote work.Job Overview:Pay Range: $35 - $39/hour. Employee benefits encompass health insurance (including medical, dental, and vision), a 401(k) plan, and paid sick...
-
Patient Insurance Coordinator
2 weeks ago
Longview, Texas, United States Christus Health Full timePosition Overview:The Insurance Verification Clerk plays a crucial role in ensuring that all scheduled and unscheduled patients have their insurance eligibility confirmed. This involves direct communication with insurance providers and the use of our electronic eligibility system. The clerk will also analyze eligibility data to provide estimates of patient...
-
Route Maintenance Specialist
5 days ago
Longview, Texas, United States ABM Full timeJob SummaryThe Route Maintenance Specialist position provides the cleaning and upkeep of assigned areas for ABM, a leading facilities management company.Key ResponsibilitiesClean and maintain buildings and facilities to ensure a safe and healthy environment for clients and employees.Notify management of any maintenance or repair needs, including minor or...
-
Customer Support Specialist
20 hours ago
Longview, Texas, United States iClassPro, Inc. Full timeiClassPro, Inc. is a leading provider of class management software solutions for children's activity centers. We're seeking a skilled Customer Support Representative to join our team. As a key member of our support team, you will be responsible for providing exceptional customer service to our clients. Your primary duties will include responding to customer...