Precertification Specialist

OneOncology • San Antonio, TX

3d

About The Position

position responsible for coordinating care requests based on physician orders, benefits, appropriateness and carrier criteria. Obtain insurance carrier preauthorizations for chemotherapy and radiation procedures performed at inpatient and outpatient settings.

Requirements

• 1 – 3 years of oncology or hematology experience.
• Eligible candidate should be familiar with general precertification requirements, benefits analysis and obtaining and reporting clinical data for the purposes of proving medical necessity.
• Position requires skills in data entry, filing, fax and copiers.
• Good oral and written communications skills required.
• Must be fluent in English.

Responsibilities

• Precertifications for inpatient and outpatient procedures.
• Precertifications for in office chemotherapy and radiation services.
• Obtain appropriate clinical documentation and report data to carriers for purposes of proving medical necessity.
• Maintain a filing/documentation system.
• Serve as a liaison between clinical staff, facilities, and patients regarding coordination of care.
• Performs utilization review as determined by Reimbursement Dept.
• Other duties as assigned.

Benefits

• competitive wages
• benefits
• yearly bonus opportunities
• nine paid holidays

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed