Cancer Care Precertification Specialist

St. Elizabeth Healthcare•Edgewood, KY

1d•Onsite

About The Position

St. Elizabeth Healthcare is hiring a Cancer Care Precertification Specialist for our Cancer Care unit located within the Edgewood Hospital. This position exists to enhance customer service, while securing accounts according to standard protocols and payer requirements as well as provide patient access to potential coverage options or assistance programs. Perform eligibility and benefit analysis for all treatment and exams, i.e., chemotherapy or radiation oncology. Obtain authorization as needed from referring physician office and verify for accuracy. Completes verification, benefit analysis, and authorization for specified OP procedures/appointments directly with the insurance payer. Review patient schedule to ensure appropriate pre-certifications are obtained based on medical treatment plan and exams. Follow-up as needed with scheduling conflicts or problems. Work with other departments and outside entities to establish a positive working relationship that promotes cooperation and teamwork. Uses strong customer service skills that reflect Mission, Vision, and Values statement of the St. Elizabeth HealthCare. Maintains strict patient confidentiality at all times.

Requirements

High School Diploma or GED
PC skills, including Word and Excel.
Strong Interpersonal and organization skills.
Data Entry Skills above 100 Net Key strokes/min.
1 year Health care experience including: registration, scheduling, verification or authorization process, interpreting healthcare insurance plans from commercial, state, and federal payers, clerical experience.

Nice To Haves

Possible evening or weekend hours.

Responsibilities

Securing a patient account from the initial interaction through the performed treatment or exam.
Verification, authorization, pre collection process and scheduling exams, and pre-registering.
Perform eligibility and benefit analysis for all treatment and exams, i.e., chemotherapy or radiation oncology.
Obtain authorization as needed from referring physician office and verify for accuracy.
Completes verification, benefit analysis, and authorization for specified OP procedures/appointments directly with the insurance payer.
Review patient schedule to ensure appropriate pre-certifications are obtained based on medical treatment plan and exams.
Follow-up as needed with scheduling conflicts or problems.
Work with other departments and outside entities to establish a positive working relationship that promotes cooperation and teamwork.
Uses strong customer service skills that reflect Mission, Vision, and Values statement of the St. Elizabeth HealthCare.
Maintains strict patient confidentiality at all times.
Responsible for completing annual hospital and department educational requirements.
Attends meetings and webinars as assigned.
Adhere to policy and procedures of St. Elizabeth HealthCare.
Performs other duties as assigned.
May schedule and/or pre-register OP procedures/appointments from physician’s offices, patients, or other ancillary departments via telephone inquiry, fax request or CPOE WQ.