Oncology Insurance Authorization Specialist

US Oncology Network-wide Career Opportunities; Eugene (OR); On-site; USD 30,307 - 44,083; Full time

Benefits offered by this job

Medical, Dental, Vision

Life Insurance

401(k)

Job summary

Willamette Valley Cancer Institute is seeking an Insurance Reviewer to support patients by navigating insurance portals and obtaining authorizations for infusion, radiation therapy, imaging, genetics and surgeries. The role emphasizes high-volume workflow and the ability to manage shifting priorities in a clinical setting.

The position offers a general pay scale of $22.00-$32.00 per hour, with full-time employment status and benefits including medical, dental, vision, life insurance and a

Qualifications

• Minimum three (3) years of prior authorization experience required.
• Revenue cycle knowledge preferred.

Responsibilities

• Reviews, processes and audits the medical necessity for treatments including radiation oncology, gynecologic surgery, genetic lab testing, imaging, and chemotherapy treatment for each patient.
• Communicate with nursing, physician, pharmacists and medical staff to inform them of any restrictions or special requirements in accordance with particular insurance plans.
• Updates coding/payer guidelines for clinical staff. Tracks pathways and performs various other business office functions on an as needed basis.
• Obtains insurance authorization and pre-certification for various oncology & hematology related services.
• Maintains a good working knowledge of chemotherapy authorization requirements for all payers, State and federal regulatory guidelines for coverage and authorization.
• Adheres to confidentiality, state, federal, and HIPAA laws and guidelines with regards to patient's records.
• Other duties as requested or assigned.

Skills

Prior authorization experience

Revenue cycle knowledge

Education

High school diploma

Job description

Willamette Valley Cancer Institute is seeking an Insurance Reviewer to support patients by navigating insurance portals and obtaining authorizations for infusion, radiation therapy, imaging, genetics and surgeries. The role emphasizes high-volume workflow and the ability to manage shifting priorities in a clinical setting.

The position offers a general pay scale of $22.00-$32.00 per hour, with full-time employment status and benefits including medical, dental, vision, life insurance and a