Physician Practice Representative- Pediatric Hematology/Oncology

KIDZ MEDICAL SERVICE.•West Palm Beach, FL

3d•Onsite

About The Position

Join a compassionate and mission-driven team as a full-time Physician Practice Representative supporting a busy pediatric hematology/oncology practice at Palm Beach Children’s Hospital, located within St. Mary’s Medical Center. This position is ideal for someone who thrives in a fast-paced healthcare environment, enjoys multitasking, and takes pride in delivering exceptional patient support. You’ll play a key role in managing insurance verification, scheduling new and follow-up appointments.

Requirements

High school diploma or general education degree (GED), or 2+ years related experience and/or training, or equivalent combination of education and experience.
Computer skills required: Microsoft Outlook, Word, Excel and Adobe; Experience working with medical practice management software a plus.
Experience working in a physician practice.
Knowledge of medical terms and medical insurance
Experience in requesting/submitting prior authorization for various diagnostic exams, prescriptions, etc.
Professional demeanor and appearance.
Strong interpersonal and communication skills.
Meticulous attention to detail.
Proficient in Microsoft Office Suite (Word, Excel, Outlook)

Nice To Haves

Bilingual Preferred

Responsibilities

Inputs new patient information and updates information in our EMR system
Analyzes patient records and insurance policies to determine if procedures, treatments, or medications require prior authorization
Ensure patients are eligible for services and that insurance benefits are accurate
Notifies providers of potential coverage options
Communicates with patients about the authorization process and any potential delays or financial implications.
Interacts with healthcare providers, insurance companies, and patients to obtain and provide information needed for authorization decisions
Compiles and submits detailed authorization requests to insurance companies, including all necessary documentation
Completes/obtains authorizations and referrals for services, including appointments, procedures, infusions, and medications
Researches and resolves any issues or discrepancies related to authorization requests
Monitors and follows up on authorization requests to ensure timely processing
Investigates insurance denials and resubmit requests or appeals when necessary.
Monitors schedule for potential issues
Remains informed about healthcare industry regulations, trends and insurance policies
Performs other related duties as assigned by management.