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Authorization Specialist

2 months ago

Knoxville, Tennessee, United States Tennessee Full time

Position Overview:

Your Role is Vital

Are you ready to leverage your expertise to significantly impact the lives of patients and their families? At Tennessee Cancer Specialists, our employees play a crucial role in supporting patients throughout their cancer treatment journey. Every position, whether patient-facing or in a support capacity, contributes to our mission of providing exceptional, compassionate care. Our dedicated team of over 200 professionals across 16 locations in East Tennessee has earned recognition as a Top Workplace in the greater Knoxville area.

As an Authorization Specialist, your primary responsibility will be to assist healthcare providers in securing prior authorizations from various insurance companies for prescribed medications and treatments.

A Day in Your Life:

In this full-time role, you will utilize your knowledge to facilitate authorization for patient care while addressing any obstacles that may arise. Your strong customer service abilities will enable you to communicate effectively with insurance payors, ensuring timely processing of treatment plans. Collaborating with a team of committed professionals, you will troubleshoot challenges and serve as a key contact for clinic teams, addressing inquiries and supporting additional needs.

Balancing the tenacity required to engage with insurance providers and the compassion necessary for patient interactions is essential, and your professionalism will guide you in achieving this balance.

Key Responsibilities:

  • Your understanding of chemotherapy, immunotherapy, and infusion treatment authorization processes across various payors will keep you ahead in the pre-certification landscape.
  • Delivering outstanding customer service, you will engage with patients, colleagues, and providers, actively listening and asking pertinent questions.
  • You will provide timely updates to physicians, management, and clinical staff regarding insurance restrictions, special requirements, and potential issues related to specific plans.
  • With a patient-centered approach, you will investigate alternative solutions for obtaining authorizations and identify trends with specific treatments and payors.
  • Your proactive work ethic will prepare you to assist with additional tasks as needed.

Qualifications:

Essential Requirements:

  • A high school diploma or equivalent is required; an associate degree in a business-related field is preferred.
  • Previous experience as a medical assistant or LPN will be advantageous.
  • Proficiency in electronic health records, insurance portals, and Microsoft Office Suite (Outlook, Word, Excel, etc.) is essential.
  • At least one year of relevant experience in pre-certification, benefits verification, or similar roles is preferred.

Physical Requirements:

The physical demands of this position include regular sitting and use of hands for tasks. Occasional standing, walking, and lifting up to 30 pounds may be required. Vision and hearing must be corrected to normal ranges.

Work Environment:

This role is primarily office-based, involving frequent interactions with patients, clinical staff, and insurance representatives.