Oncology Insurance Verification Specialist

US Oncology Inc.; Ocala (FL); On-site; USD 48,000 - 64,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Life Insurance

Short-term disability

Long-term disability

Paid time off

401k with company match

Wellness program

Tuition reimbursement

Employee Assistance Program

Discounts

Job summary

US Oncology Inc. in Ocala, FL is seeking a qualified professional to review chemotherapy regimens for medical necessity and obtain necessary pre-certifications.

In this role you will communicate with nursing and medical staff, assist physicians with pathway documentation, and help prevent insurance delays by addressing payer issues. You will update payer guidelines, track pathways, and perform related business office tasks, while ensuring confidentiality and compliance with state and federal

Qualifications

• High school degree or equivalent.
• Associates degree in Healthcare, LPN state license and registration preferred.
• Minimum three (3) years medical insurance verification and authorization required.

Responsibilities

• Reviews and audits medical necessity for chemotherapy treatments.
• Communicates with nursing and medical staff regarding insurance requirements.
• Provides feedback on pathway documentation issues and payer complications.
• Obtains insurance authorization and pre-certification for chemotherapy services.
• Assists patients and physicians by identifying alternative resources when needed.
• Maintains confidentiality and compliance with state and federal regulations.

Skills

Insurance verification

Pre-certification

Payer coordination

Communication with clinical staff

Attention to detail

Education

Associates degree in Healthcare

LPN license (preferred)

Tools

Medical billing software

Coding/payer guidelines

Job description

US Oncology Inc. in Ocala, FL is seeking a qualified professional to review chemotherapy regimens for medical necessity and obtain necessary pre-certifications.

In this role you will communicate with nursing and medical staff, assist physicians with pathway documentation, and help prevent insurance delays by addressing payer issues. You will update payer guidelines, track pathways, and perform related business office tasks, while ensuring confidentiality and compliance with state and federal