Chemo Authorization Specialist - Patient Liaison & Payer

Virginia Cancer Specialists, P.C.; Fairfax (VA); On-site; USD 40,000 - 60,000; Full time

Job summary

Virginia Cancer Specialists, an affiliate of McKesson Specialty Health and US Oncology, is seeking a Full Time Chemo Authorization Specialist for our Administrative Office in Fairfax, Virginia. Under general supervision verifies insurance eligibility, benefits, verification, prior authorization and researches denied services to ensure payments are processed on a timely basis.

Acts as a liaison to ensure accurate processing of all claims and supports the US Oncology Compliance Program, including

Qualifications

• Minimum high school degree or equivalent.
• Associates degree in healthcare preferred.
• Licensure or certification (LPN license or Pharmacy Tech) preferred.
• Minimum two years medical insurance verification and authorization experience.
• Billing and coding experience preferred.

Responsibilities

• Reviews and audits medical necessity for chemotherapy treatment documentation.
• Acts as liaison between patient and payer to resolve reimbursement questions and delays.
• Obtains insurance authorization and pre-certification for chemotherapy services.
• Researches non-covered services and directs patients to financial resources.
• Coordinates with staff on payer requirements and pathway documentation.
• Maintains knowledge of payer guidelines and tracks authorization trends.

Skills

Insurance verification

Authorization

Billing and coding

Patient advocacy

Education

High school diploma or equivalent

Associates degree in Healthcare

LPN Virginia State License

Certified Pharmacy Technician

Job description

Virginia Cancer Specialists, an affiliate of McKesson Specialty Health and US Oncology, is seeking a Full Time Chemo Authorization Specialist for our Administrative Office in Fairfax, Virginia. Under general supervision verifies insurance eligibility, benefits, verification, prior authorization and researches denied services to ensure payments are processed on a timely basis.

Acts as a liaison to ensure accurate processing of all claims and supports the US Oncology Compliance Program, including