Oncology Prior Authorization Specialist

The US Oncology Network; Eugene (OR); Sur place; USD 36 000 - 41 000; Plein temps

Avantages offerts par ce poste

Medical, Dental, Vision

Life Insurance

401(k)

Résumé du poste

The US Oncology Network in Eugene, OR is seeking a Prior Authorization Specialist/Insurance Reviewer - Clinical to secure insurance authorizations for patient treatments and procedures. You will partner with care teams and payers to minimize delays while maintaining strict HIPAA and confidentiality.

The role requires at least three years of prior authorization experience; revenue cycle familiarity is preferred.

Qualifications

• High school degree or equivalent.
• Minimum three (3) years of prior authorization experience.
• Revenue cycle experience preferred.

Responsabilités

• Reviews, processes and audits the medical necessity for treatments including radiation oncology, gynecologic surgery, genetic lab testing, imaging, and chemotherapy treatment for each patient.
• Communicates 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 as needed.
• Obtains insurance authorization and pre-certification for various oncology and hematology related services.
• Maintains knowledge of chemotherapy authorization requirements for all payers; adheres to confidentiality and HIPAA laws.

Connaissances

Prior authorization

Attention to detail

Communication with care teams

Formation

High school diploma or equivalent

Description du poste

The US Oncology Network in Eugene, OR is seeking a Prior Authorization Specialist/Insurance Reviewer - Clinical to secure insurance authorizations for patient treatments and procedures. You will partner with care teams and payers to minimize delays while maintaining strict HIPAA and confidentiality.

The role requires at least three years of prior authorization experience; revenue cycle familiarity is preferred.