Referral-Auth Specialist

Job description

DEPARTMENT: ONCOLOGY CENTER #7190
POSITION SUMMARY:
Under minimum supervision is responsible for acquiring, initiating, verifying and securing benefits and eligibility for medical oncology and hematology outpatient services. Works with physician offices, insurance carriers, scheduling, business office and third party providers in securing authorizations/pre-certs for services being provided.
ESSENTIAL JOB FUNCTIONS:
• Treatment Authorizations: Acquire chemotherapy, biotherapy and infusion therapy authorizations by submitting clinical documentation to the carrier for approval.
• Coordinates and works with physician offices, case management/ utilization review, insurance carriers, scheduling, Business Office and third party payers in securing authorizations/Pre-Certs.
• Ensures payment for services by verifying benefits and procedure/drug codes with insurance carriers.
• Monitors and tracks for expired patient authorizations.
• New Patient Referrals: Is responsible for acquiring pertinent information for new referrals.
• Preparing new referral packets for review and approval by the Clinical Manager and Physician.
• Assist front office staff if needed with registration of patients, and answering phones.
• Performs other duties as assigned.

EDUCATION, EXPERIENCE, TRAINING:
• High School preferred
• Word/Excel programs