Oncology Pre-Authorization & Patient Access Specialist

OneOncology; United States; Vor Ort; USD 42.000 - 65.000; Vollzeit

Zusammenfassung

OneOncology is seeking a Patient Financial Services liaison to coordinate pre-authorizations and reimbursement issues across clinical and billing teams. You will educate patients on coverage, estimate out‑of‑pocket costs, and ensure timely documentation in EMR and Patient Management systems.

The role requires collaborating with physicians and staff to clarify treatment plan requirements, navigate insurance programs, and support indigent drug coordination.

Qualifikationen

• High School diploma or equivalent.
• Medical insurance background.
• Must be willing and able to lift up to 25 pounds.
• Must be willing and able to travel to satellite clinics when necessary.

Aufgaben

• Obtains pre-authorizations for Physician Orders as required by the patient’s insurance carrier.
• Communicates with physician/clinical staff on reimbursement issues and/or pre-certification requirements by the patient’s insurance carriers.
• Communicates with physician/clinical staff concerning off label drug use.
• Coordinates and communicates information required or requested by Patient Accounting within the mandated timeframe.
• Ensures up-to-date documentation on patient’s accounts in Electronic Medical Record and Patient Management on follow up or ongoing drug authorizations.
• Keeps current on drug and insurance carrier requirements. Utilizing all sources available to stay abreast of drug information.
• Follows policy and procedures outlined by management to ensure standardization of processes across the clinics.
• Responsible for patient assistance coordination with the Patient Advocate and communicates with clinical staff to coordinate treatment plan requirements for indigent drug.
• Educate patients about their insurance coverage and benefits, including deductible, copay, coinsurance and estimated out of pocket costs as needed.
• Determine patient financial ability to pay and provide financial counseling services regarding payment arrangements and financial assistance for uninsured and underinsured patients by phone or in person as needed.
• Maintains continued authorizations of drugs ensuring that all treatment dates are covered for reimbursement.
• Resolve items in task management related to drug authorization issues.
• Additional responsibilities as assigned to help drive our mission of improving the lives of everyone living with cancer.

Kenntnisse

Communication

Customer service

Attention to detail

Organization

Problem solving

Ausbildung

High School diploma or equivalent

Tools

MS Word

Excel

Outlook

EMR systems

Jobbeschreibung

OneOncology is seeking a Patient Financial Services liaison to coordinate pre-authorizations and reimbursement issues across clinical and billing teams. You will educate patients on coverage, estimate out‑of‑pocket costs, and ensure timely documentation in EMR and Patient Management systems.

The role requires collaborating with physicians and staff to clarify treatment plan requirements, navigate insurance programs, and support indigent drug coordination.