Oncology Insurance Reimbursement Specialist

US Oncology Network-wide Career Opportunities; Norfolk (VA); On-site; USD 42,000 - 65,000; Full time

Job summary

US Oncology Network-wide Career Opportunities is seeking an Insurance Verification Specialist to review chemotherapy regimens for medical necessity and obtain pre-certifications. The role supports compliance and collaborates with nursing and billing staff to prevent delays in reimbursement.

Qualified candidates should have a high school diploma, an associate degree in healthcare, or an LPN license (preferred), and at least three years of medical insurance verification experience, with strong

Qualifications

• High school diploma or equivalent is required.
• Associate degree in Healthcare; LPN license and registration preferred.
• Minimum three years medical insurance verification and authorization experience required.

Responsibilities

• Review, process and audit medical necessity for chemotherapy treatments and documentation.
• Communicate with nursing and medical staff regarding payer restrictions and pathway documentation.
• Update coding/payer guidelines for staff and track pathways; assist with payer issues.
• Obtain insurance authorization and pre-certification for chemotherapy services; act as liaison between patient and payer.

Skills

Technical expertise

Adaptability

Judgment

Work ethic

Quality focus

Education

High school diploma or equivalent

Associate degree in Healthcare

LPN license (preferred)

Job description

US Oncology Network-wide Career Opportunities is seeking an Insurance Verification Specialist to review chemotherapy regimens for medical necessity and obtain pre-certifications. The role supports compliance and collaborates with nursing and billing staff to prevent delays in reimbursement.

Qualified candidates should have a high school diploma, an associate degree in healthcare, or an LPN license (preferred), and at least three years of medical insurance verification experience, with strong