Patient Access Coordinator - Cancer Center (Full-Time Days) - Jefferson-Einstein Philadelphia

Thomas Jefferson University•Philadelphia, PA

2d•Onsite

About The Position

The primary responsibility of this role is to obtain prior authorization from insurance companies for patients receiving chemotherapy. This involves electronically accessing insurance company website portals and/or contacting them via telephone or fax to request prior authorization. The coordinator must ensure appropriate ICD-10 codes are associated with the patient's EMR prior to these requests. They will also communicate prior authorization status with the treatment team (nurses/doctors/manager) and appropriately document denied/approved authorizations. Additionally, the role involves verifying patient demographic and insurance information in RCX and Cerner billing systems, batching all ICD-10 and CPTs for outpatient billing documentation, and entering charge batches into RCX rules and Cerner billing systems in a timely fashion. The coordinator will also reconcile batch totals, log and file information, and manage denials for all authorization-rejected claims.

Requirements

High School Diploma required.
At least one year billing experience required.
Knowledge of CPT and ICD-10 coding.
Knowledge of patient registration.
Knowledge of third party insurances.

Nice To Haves

Experience with RCX rules, Cerner Registration, iPAS, Cerner and RCX charge entry and payment posting functions preferred.
Knowledge of Artiva Denial Management preferred.
Knowledge of Chemotherapy drugs preferred.

Responsibilities

Obtain prior authorization from insurance companies for patients receiving chemotherapy.
Electronically access insurance company website portals and/or contact via telephone or fax to request prior authorization.
Ensure appropriate ICD-10 codes are associated with the patients EMR prior to prior authorization requests.
Communicate with treatment team (nurses/doctors/manager) on prior authorization status.
Appropriate documentation of denied/approval authorizations.
Verify patient demographic and insurance information in RCX and Cerner billing systems.
Batch all ICD-10 and CPTs for outpatient billing documentation.
Enter charge batches into RCX rules and Cerner billing systems in a timely fashion.
Reconcile batch totals, log and file.
Denial management for all authorization rejected claims.

Benefits

Medical (including prescription)
Supplemental insurance
Dental
Vision
Life and AD&D insurance
Short- and long-term disability
Flexible spending accounts
Retirement plans
Tuition assistance
Voluntary benefits (access to group rates on insurance and discounts)
Tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service.