Laboratory Authorization Specialist

OneOncology

19h•Remote

About The Position

OneOncology is positioning community oncologists to drive the future of cancer care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer. Our team is bringing together leaders to the market place to help drive OneOncology’s mission and vision. Why join us? This is an exciting time to join OneOncology. Our values-driven culture reflects our startup enthusiasm supported by industry leaders in oncology, technology, and finance. We are looking for talented and highly-motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of community oncologists and the patients they serve. Job Description: The Laboratory Authorization Specialist is responsible for ensuring reimbursement requirements for laboratory services, including benefit verification and authorization, are met. The Laboratory Authorization Specialist functions as a liaison between clinical, lab, and Patient Accounting staff, ensuring authorization or other reimbursement requirements are in place before laboratory testing is conducted.

Requirements

Excellent written and verbal communication skills with the ability to effectively communicate and establish collaborative relationships with physicians, patients, clinical and administrative staff.
Excellent customer service skills.
Ability to multi-task and prioritize.
Ability to recognize, evaluate and solve problems.
Strong organizational skills and attention to detail.
Proficient in the use of computer applications including but not limited to practice management, EMR, Copia and other medical information systems.
High School diploma or equivalent required
Previous prior authorization experience required

Nice To Haves

Knowledge of clinic office procedures, medical practice, medical terminology and laboratory services preferred.

Responsibilities

Act as the liaison and primary point of contact for the Business Office, Tennessee Oncology laboratory and other cross-functional laboratory lines of business.
Obtain prior authorizations for physician laboratory orders as required by the patient insurance carriers
Maintain a working knowledge of insurance requirements/policies and communicating them to all applicable parties.
Communicates with physician/clinical staff on reimbursement issues and/or pre-certification requirements.
Ensures up-to-date documentation on patient’s accounts in Electronic Medical Record and Patient Management System on follow up and/or ongoing laboratory authorizations.
Follows policy and procedures outlined by management to ensure standardization of processes.
Monitor all orders received through the external portal and follow the established workflow for identification of missing information, case creation, communication with HMS staff, monitoring of case status and communication with outside vendors/clients.
Possess a working knowledge of laboratory testing including CPT and ICD10 coding, as well as billing regulations.
Maintains continued authorizations of laboratory services, ensuring all treatment dates are covered for reimbursement.
Resolves items related to laboratory authorization issues, in timely manner.
Other duties as assigned to help drive our mission of improving the lives of everyone living with cancer.