Remote Oncology Insurance Authorization Specialist

Oncology Voice Network LLC; Odessa (TX); Hybrid; USD 38,000 - 52,000; Full time

Job summary

Texas Oncology in Odessa, TX is hiring an Insurance Authorization Specialist for a full-time remote role supporting the Laboratory Department. You review chemotherapy regimens for reimbursement, obtain pre-certifications, and coordinate with nursing and medical staff to avoid delays.

The ideal candidate has a high school diploma (associates preferred) and 3+ years of medical insurance verification; Sr. level requires additional clinical review experience. Work hours are Mon–Fri, 8:00a–5:00p.

Qualifications

• High school degree or equivalent; associate's degree preferred.

Responsibilities

• Reviews, processes and audits medical necessity for chemotherapy treatment and documentation.
• Communicates with nursing and medical staff about restrictions per insurance plans.
• Updates coding/payer guidelines for clinical staff.
• Obtains insurance authorization and pre-certification for chemotherapy services.
• Researches additional resources for non-covered services to prevent denials.
• Maintains knowledge of authorization requirements and HIPAA guidelines.
• Other duties as assigned.

Skills

Medical insurance verification

Pre-certifications

Payer communications

Education

Associates degree in Healthcare

LPN license and registration

Job description

Texas Oncology in Odessa, TX is hiring an Insurance Authorization Specialist for a full-time remote role supporting the Laboratory Department. You review chemotherapy regimens for reimbursement, obtain pre-certifications, and coordinate with nursing and medical staff to avoid delays.

The ideal candidate has a high school diploma (associates preferred) and 3+ years of medical insurance verification; Sr. level requires additional clinical review experience. Work hours are Mon–Fri, 8:00a–5:00p.