Oncology Insurance Authorization Specialist

US Oncology Inc.; Eugene (OR); On-site; USD 36,000 - 40,000; Full time

Benefits offered by this job

Medical/Dental/Vision

Life Insurance

401(k)

Job summary

Willamette Valley Cancer Institute in Eugene, Oregon, seeks an Insurance Reviewer to support patients by navigating insurance portals and obtaining authorizations for infusion drugs, radiation therapy, imaging, genetics and surgeries. This role focuses on authorizations to keep treatment on path and ensure payer requirements are met.

The position is full-time in a high-volume clinic. The reviewer collaborates with nursing, physicians and staff to resolve payer issues and maintain documentation

Qualifications

• High school degree or equivalent required.
• Minimum three years of prior authorization experience required.

Responsibilities

• Reviews, processes and audits medical necessity for treatments and documents regimen per payer guidelines.
• Communicates with nursing, physicians, pharmacists and staff about restrictions or special requirements from insurance plans.
• Updates coding/payer guidelines for staff and tracks pathways as needed.
• Obtains insurance authorization and pre-certification for oncology & hematology services.
• Maintains knowledge of chemotherapy authorization requirements for all payers and regulatory guidelines.
• Adheres to HIPAA and confidentiality; performs other duties as assigned.

Skills

Prior authorization experience

Education

High school degree or equivalent

Job description

Willamette Valley Cancer Institute in Eugene, Oregon, seeks an Insurance Reviewer to support patients by navigating insurance portals and obtaining authorizations for infusion drugs, radiation therapy, imaging, genetics and surgeries. This role focuses on authorizations to keep treatment on path and ensure payer requirements are met.

The position is full-time in a high-volume clinic. The reviewer collaborates with nursing, physicians and staff to resolve payer issues and maintain documentation