Complex Authorization Coordinator - Cancer Center Days - 40hrs/wk.
About The Position
Under limited direction, the Complex Authorization Coordinator consults with patients to obtain insurance verification and/or authorization and financial clearance for pediatric and adult cancer and non-cancer infusions. This role involves benefit investigation, reviewing patient out-of-pocket expenses, deductibles, step therapy trials and failures, FDA, NCCN and/or LCD for diagnosis and dosing, site of care insurance mandates, reviewing for biosimilars, outmigration to home authorization, white bagging requirements, patient assistance programs, and handling appeals and denials for off-label drug requests.
Requirements
- High school diploma or GED
- Minimum of 3-4 years of related experience
- Excellent time management skills and ability to prioritize tasks
- Flexibility to work independently and handle multiple tasks
- Ability to provide support, direction, and development of staff
- Ability to skillfully handle issues of a sensitive nature with respect to confidentiality and organizational guidelines
- Excellent interpersonal skills and communication skills
- Excellent computer skills
- Training or experience in managed care insurance plans
- Knowledge of appointment scheduling process
- Communicate effectively, both verbal and written
- Able to prioritize, maintain accurate records, and work under deadline
- Excellent customer service skills
Responsibilities
- Obtain insurance approvals for Adult and Pediatric Cancer and Non-Cancer Infusion Services.
- Review patient benefit level to determine cost share and out-of-pocket expense for upcoming procedures and infusion services.
- Communicate cost share expectations to patients and collect pre-payment for services.
- Verify and update patient demographic and insurance information.
- Provide insurance verification for coverage changes.
- Manage daily work queues.
- Incorporate and practice Lean principles into daily work.
- Function as a collaborative and contributing team member.
- Demonstrate outstanding customer service skills.
- Schedule new and return complex, adult non-cancer infusion appointments, determining appropriate clinic and utilizing scheduling guidelines and informational tools.
- Participate on committees, task forces, and workgroups charged with improving referral operations and patient care.
- Maintain a current knowledge base of department processes, protocols, and procedures.
- Pursue self-directed learning and continuing education opportunities.
- Perform other duties as assigned.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
