Administrative Supervisor - Oncology, Authorizations

University of California - Los Angeles Health; Los Angeles (CA); On-site; USD 45,000 - 89,000; Full time

Job summary

University of California seeks an experienced professional to develop and implement authorizations training procedures and evaluation methods. You will collaborate with the clinical research unit to ensure that research patient treatments are properly authorized for reimbursement.

The role also involves liaising with the professional billing office to expedite documentation for appeal processing and to support accurate claims denial resolutions.

Qualifications

• Knowledge of oncology CPT and ICD-10 codes and medical office procedures.
• Working knowledge of insurance authorizations and verification process for major medical insurance plans.
• Healthcare research and analysis skills sufficient to support drug coverage and reimbursement.
• Possess strong customer service skills to promote pleasant interactions with patients, staff and physicians.
• Skills in analyzing information, problems, situations, practices and procedures to provide solutions while maintaining cooperation with administrators, physicians, peers and the public.
• Ability to work as part of a team and maintain confidentiality in all assignments.
• Advanced organizational skills to accomplish objectives.
• Knowledge of State and Federal programs to ensure reimbursement from Medicare, Medi-Cal, or other payers.
• Ability to set priorities and complete assignments in a timely manner under supervision.

Responsibilities

• Develop and implement authorizations training procedures and evaluation methods.
• Interact with the clinical research unit to ensure active research patient treatments are accurately authorized for reimbursement.
• Liaise with the professional billing office to ensure timely submission of requested clinical documentation to process appeals.

Skills

Customer service

Interpersonal skills

Prioritization

Teamwork

Communication

Problem solving

Confidentiality

Organizational skills

Tools

Microsoft Word

Excel

Outlook

CareConnect

Billing systems

Internet

Job description

Description

In this role, you will be responsible for developing and implementing authorizations training procedures and evaluation methods. In addition, you will interact with the clinical research unit to ensure active research patient treatments are accurately authorized to ensure reimbursement for cancer therapies. Further, you will liaise with the professional billing office when claims are denied to ensure timely submission of requested clinical documentation to process appeals.

Salary range: $32.42/hr - $64.51/hr

Qualifications

Required:

• Knowledge of oncology CPT and ICD-10 codes and medical
  office procedures.General knowledge of
  oncology procedures and terminology.
• Working knowledge of insurance authorizations and
  verification process for major medical insurance plans.
• Healthcare research and analysis skills sufficient to
  support drug coverage and reimbursement.
• Experience with varied computer software and hardware
  including:knowledge of Microsoft Word,
  Excel and Outlook, CareConnect, billing systems and the internet.
• Possess strong customer service skills to promote pleasant
  and effective interactions with patients, staff and physicians.
• Skills in analyzing information, problems, situations,
  practices and procedures to recognize alternatives and provide solutions while
  maintaining cooperative working relationships with administrators, physicians,
  peers and the public.
• Ability to work as part of a team, maintaining
  confidentiality in all assignments and show initiative in identifying and
  solving problems as they occur.
• Ability to set priorities and complete assignments in a
  timely manner under minimal supervision.
• Advanced organizational skills to ensure a workable,
  efficient workspace and accomplish established objectives.
• Skills in adapting to and implementing frequently changing
  procedures.
• Knowledge of State and Federal programs to ensure
  reimbursement from Medicare, Medi-Cal, or other sponsoring agencies as well ask
  knowledge of reimbursement guidelines for commercial and managed care payers.
• Skill in recognizing a high priority situation and taking
  appropriate and immediate action.
• Ability to maintain composure when confronted with difficult
  situations and respond professionally.
• Ability to make independent judgements and to evaluate
  complex, sensitive issues with diplomacy
• Skill in speaking clearly and using appropriate grammar.
• Skill in writing concise, grammatically correct
  reports/correspondence.
• Ability to perform basic mathematical functions.
• Working knowledge of medical terminology to sufficiently
  identify various procedures to obtain optimum benefit information and
  reimbursement.
• Working knowledge of third party payor verification
  terminology.
• Knowledge in the functional operations of third party payors
  and utilization review agencies to expeditiously coordinate follow-up.
• Interpersonal skills to interact with all members of the
  healthcare team to develop and maintain a cooperative working environment.
• Minimum of two years of previous supervisory experience
• Ability to set priorities and complete assignments in a
  timely manner.
• Ability to evaluate situations and appraise supervisor of
  all exceptional and non-standard activities upon occurrence.
• Demonstrated ability to be punctual and maintain a
  satisfactory attendance record.
• Demonstrated ability to adhere to departmental policies and
  procedures and work rules.
• Ability to perform other tasks and duties as assigned.