Remote Oncology Insurance Authorization Specialist

Us Oncology Inc; Wylie (TX); Remote; USD 42.000 - 64.000; Vollzeit

Zusammenfassung

The US Oncology Network is seeking an Insurance Authorization Specialist to support the Oncology Department at the Abilene clinic. This full-time remote role may be Level 1 or Sr based on experience, with typical hours Monday–Friday, 8:00am–5:00pm.

Responsibilities include pre-certifications, denial research, payer communications, and maintaining compliance with confidentiality and regulatory guidelines.

Qualifikationen

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

Aufgaben

• Review medical necessity for chemotherapy treatments and document adherence to pathways.
• Communicate with nursing and medical staff regarding restrictions or payer issues.
• Update coding/payer guidelines for clinical staff; track pathways and perform related office duties.
• Obtain insurance authorization/pre-certification for chemotherapy; act as liaison between patient and payer.
• Research additional resources for non-covered services to prevent denials; provide patient resource contacts.
• Maintain knowledge of chemotherapy authorization requirements for all payers and comply with privacy laws.
• Other duties as assigned.

Kenntnisse

Medical insurance verification

Authorization management

Communication with nursing staff

Payment & payer guidelines

Patient advocacy

Confidentiality & compliance

Ausbildung

High school diploma or equivalent

Associates degree in Healthcare / LPN preferred

Jobbeschreibung

The US Oncology Network is seeking an Insurance Authorization Specialist to support the Oncology Department at the Abilene clinic. This full-time remote role may be Level 1 or Sr based on experience, with typical hours Monday–Friday, 8:00am–5:00pm.

Responsibilities include pre-certifications, denial research, payer communications, and maintaining compliance with confidentiality and regulatory guidelines.