Come join our world class team and help us bring cancer treatment home!
Highlands Oncology began in 1996 with three physicians and a desire to change the face of oncology care in our community. Our founding physicians knew that patients do better at home, in the community where they live and work, and where their support system is already in place. In furthering that goal, Highlands has grown with the region from a single location 26 years ago, to 6 locations in Northwest and Northcentral Arkansas today employing more than 700 diverse team members.
As Northwest Arkansas continues to grow, so must the services and providers available in the region. Highlands Oncology is committed to remaining on the cutting edge to ensure our community has access to the very best cancer care. What we have is something quite unique right here in our own backyard with a caring multidisciplinary team focused on treating patients as family.
Job Title: Precertification Analyst - Imaging
Reports To: Precertification Supervisor
Location: Northwest or North-Central Arkansas – Depending on the position, employees may be asked to move locations from time to time based on clinic and patient needs.
FLSA: non-exempt/hourly
Job Summary: The Precertification Analyst for imaging services obtains prior authorizations for services as applicable. Fills out forms online or on paper; retrieves and submits records as needed to obtain authorizations. Works with patients, insurance companies, and clinical staff members.
Job Duties / Responsibilities: Including, but not limited to, the following:
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Review of imaging schedules for Benton County Clinic, North Hills Clinic, and Parkway Clinic daily to determine the insurances that require prior authorization for imaging.
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Answers and resolves incoming calls regarding STAT requests.
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Prompt obtainment of authorization(s) for any urgent add-on requests.
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Maintain accurate and current authorization(s) information in OncoEMR and G4.
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Work closely with imaging personnel to determine what date requires review to guarantee all authorizations are obtained in a timely manner.
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Communicates with nursing and medical staff to inform them of any restrictions or special requirements in accordance with insurance plans.
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Work closely with the insurance verification team to ensure insurance coverage is up to date.
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Maintain a professional relationship with physician/nurses addressing questions, concerns regarding imaging orders/diagnoses.
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Set up peer-to-peer review as requested.
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Maintain a good working relationship with outside referring providers and staff.
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Maintain patient/clinic confidentiality.
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Ability to cover positions for Outside Treatments/Genetic Testing/In-patient Authorizations, as designated.
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Maintain pleasant/helpful attitude towards patients and staff.
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Perform all related duties as required by the Precertification Supervisor, Revenue Cycle Manager, and Business Office Director.
Required Skills/Abilities:
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Knowledge of g4/PM System & OncoEMR
- Proficient in computer skills.
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Communicates clearly and concisely.
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Ability to work independently and as part of a team.
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Ability to maintain good working relationships.
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Demonstrates attention to detail.
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Strong knowledge of medical terminology.
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Demonstrates professionalism in appearance/dress code.
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Knowledge of ICD-10-CM, HCPCS, and CPT codes.
Certifications/Licenses/Education/or Experience in a related field:
- High School Diploma or equivalent
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Minimum of 1-2 years of medical office experience, preferred.
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Prior authorization experience, preferred.
Physical Requirements:
- Will require extensive desk use and computer use.
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Light lifting may be required.
Work Environment:
- The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of the job. Reasonable accommodation may be made to enable individuals with disabilities to perform essential functions.
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Due to the nature of our business and the use of radiation and hazardous chemicals, it is imperative that all employees foster a culture and environment of safety.
Additional Requirements:
- A resignation notice of a minimum of two weeks is required. Resignation notices must be given in writing to the direct Supervisor.
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By signing this job description, the employee attests that they are or will become within a reasonable timeframe of hire: be familiar with policies and procedures, will complete all required training assignments, and follow the Code of Conduct. The employee will comply with all federal and state regulations, laws, and policies as they presently exist and as they change or are modified.
Other Duties: Please note this job description is not designed to be exhaustive. The employee may be required to perform other duties as assigned.
