Authorization Specialist-Diagnostic Imaging

The US Oncology Network•Vancouver, WA

7h•Onsite

About The Position

Compass Oncology is searching for an Authorization Specialist-Diagnostic imaging. You will play a crucial role in how our patients experience the Cancer Care Continuum by supporting our effort to make our patient experience as comfortable as possible. In this role you will be responsible for managing the complex process of insurance approval for diagnostic imaging services and making sure that any hurdles are managed with care and diligence. Employment Type: Full-Time, 40 Hours Location: On-site Vancouver, WA (1498 SE Tech Center Drive, Vancouver, WA 98683) Salary: $20.75 - $32.84 Per Hour Final offer amounts are determined by a review of the candidate’s applicable experience and qualifications, as well as internal employee equity considerations Scope: Under general supervision, reviews medical regimens in accordance with reimbursement guidelines. Obtains necessary pre-certifications and exceptions to ensure no delay in reimbursement of treatments. Research denied services and alternative resources to pay for treatment. Supports and adheres to the US Oncology Compliance Program, to include the Code of Ethics and Business Standards.

Requirements

High school degree or equivalent. Associate degree in healthcare preferred.
Minimum two (2) years of experience in medical insurance verification, authorization, or related work with a healthcare or insurance environment required.

Responsibilities

Reviews, processes, and audits the medical necessity for each patients’ treatment and documentation of regimen relative to pathway adherence.
Communicates with nursing and medical staff to inform them of any restrictions or special requirements in accordance with particular insurance plans. Provides prompt feedback to physicians and management regarding pathway documentation issues, and payer issues.
Updates coding/payer guidelines for clinical staff. Tracks pathways and performs various other business office functions on an as needed basis.
Obtains insurance authorization and pre-certification specifically for diagnostic imaging services. Works as a patient advocate and functions as a liaison between the patient and payer to answer reimbursement questions and avoid insurance delays.
Researches additional or alternative resources for non-covered services to prevent payment denials. Provides a contact list for patients’ community resources including special programs, drugs and pharmaceutical supplies and financial resources.
Other duties as requested or assigned.