Chemotherapy Benefits Navigator

US Oncology Inc.; Norfolk (VA); On-site; USD 42,000 - 64,000; Full time

Job summary

US Oncology Inc. is seeking a detail-oriented insurance verification specialist to support oncology treatment reimbursements in Norfolk, VA.

The role involves reviewing chemotherapy regimens for medical necessity and ensuring timely pre-certifications to prevent delays in payment. The position requires experience in insurance verification, authorization, and payer communications, with preference for an LPN or allied health background.

Qualifications

• High school degree or equivalent; associates degree preferred.
• Minimum three (3) years medical insurance verification and authorization experience.

Responsibilities

• Reviews and audits medical necessity for chemotherapy regimens and documents adherence to pathways.
• Communicates with nursing and medical staff regarding restrictions or payer requirements.
• Updates coding/payer guidelines for staff and tracks pathways.
• Obtains insurance authorization and pre-certification for chemotherapy services; acts as liaison between patient and payer.
• Researches additional resources for non-covered chemotherapy services and informs patients about community resources.

Skills

Medical insurance verification

Authorization processing

Staff communication

Education

Associates degree in Healthcare

LPN license (preferred)

Job description

US Oncology Inc. is seeking a detail-oriented insurance verification specialist to support oncology treatment reimbursements in Norfolk, VA.

The role involves reviewing chemotherapy regimens for medical necessity and ensuring timely pre-certifications to prevent delays in payment. The position requires experience in insurance verification, authorization, and payer communications, with preference for an LPN or allied health background.