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Cancer Treatment Authorization Coordinator
2 months ago
Position 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 committed to providing exceptional, evidence-based cancer care to patients within their communities.
With a network of approximately 530 providers across over 280 locations in Texas, we are proud to be the largest community oncology provider in the nation. Our founders established community-based cancer care to ensure that patients have access to the best treatment options while being surrounded by their loved ones.
Our mission remains steadfast—at Texas Oncology, we leverage advanced technology and research to deliver high-quality cancer care, helping our patients achieve "More breakthroughs. More victories." in their battle against cancer. We treat a significant portion of Texans diagnosed with cancer each year.
The US Oncology Network stands as one of the largest networks of community-based oncology physicians in the country, dedicated to enhancing cancer care across America.
Supported by McKesson Corporation, we focus on fostering a sustainable community patient care delivery system that advances the science, technology, and quality of care.
Key Responsibilities:
The primary duties and responsibilities include:
1. Evaluating and processing chemotherapy treatment requests to ensure compliance with reimbursement standards.
2. Collaborating with nursing and medical teams to communicate any specific requirements or limitations related to insurance plans.
3. Providing timely feedback to physicians and management regarding documentation and payer issues related to chemotherapy drugs.
4. Maintaining up-to-date coding and payer guidelines for clinical staff.
5. Securing insurance authorizations and pre-certifications specifically for chemotherapy services.
6. Acting as a patient advocate, facilitating communication between patients and payers to address reimbursement inquiries and prevent delays.
7. Researching alternative resources for non-covered chemotherapy services to minimize payment denials.
8. Compiling a list of community resources for patients, including special programs and financial assistance.
9. Keeping abreast of chemotherapy authorization requirements for all payers, as well as state and federal regulations.
10. Upholding confidentiality and adhering to state, federal, and HIPAA regulations regarding patient records.
Qualifications:
The ideal candidate for the Cancer Treatment Authorization Coordinator position will possess the following qualifications:
- High school diploma or equivalent required.
- Associate's degree in Healthcare or LPN state license preferred.
- A minimum of three (3) years of experience in medical insurance verification and authorization is preferred.
Competencies:
Technical Expertise:
Demonstrates comprehensive knowledge of the field and is recognized as an expert; utilizes additional resources when necessary.
Adaptability:
Effectively manages daily challenges; adjusts to shifting priorities and demonstrates resilience in the face of adversity.
Judgment:
Makes informed, timely decisions even under uncertain conditions.
Commitment to Quality:
Prioritizes high standards of performance and continuously seeks to improve processes and services.
Physical Requirements:
The physical demands outlined here are representative of those that must be met by an employee to successfully perform the essential functions of this role. Reasonable accommodations may be made for individuals with disabilities.
While performing the duties of this position, the employee is expected to be present during scheduled business hours, requiring sitting or standing for extended periods. The role may involve lifting and carrying items weighing up to 40 lbs and necessitates corrected vision and hearing within normal ranges.
Work Environment:
The work environment may include exposure to various health-related conditions typical of an oncology/hematology clinic. Interaction with colleagues and management is expected, and minimal travel to office sites may be required.
