JOB SPECIFIC CORE COMPETENCIES:
- Demonstrate the ability to verify patient insurance eligibility and benefits.
- Demonstrate the ability to obtain precertification for outpatient procedures with correct CPT and diagnosis codes through appropriate insurance company online, fax, and by telephone.
- Demonstrate the ability to document authorizations in Meditech and link to appropriate appointments.
- Identify and submit appropriate clinical documentation to insurance companies to support authorization requests.
- Demonstrates excellent communication skills with medical staff and patients.
- Ability to check patients in, verify demographic information, answer calls, sort and deliver faxes.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:
- Verify patient insurance eligibility and benefits on all infusion patients by verifying pre-certification note, date range, and number of cycles..
- Obtain pre certifications and authorizations for scans, labs, and infusions as assigned.
- Document authorizations in Meditech and link to appropriate appointments.
- Identify and submit appropriate clinical documentation to insurance companies to support authorization requests.
- Exhibit excellent communication skills with medical staff and patients.
- Check in patients, verify patient demographic information, answer incoming calls, and sort and deliver faxes as needed.
- Follow up on outgoing referrals as needed.
EXPECTED BEHAVIORS:
- Interacts collaboratively with team members
- Ability to maintain composure under stressful situations.
- Possesses a sense of responsibility, initiative, honesty, and confidentiality.
- Maintain satisfactory, regular and predictable attendance by reporting to work as scheduled and keeping unscheduled absences to a minimum.
EDUCATION AND EXPERIENCE REQUIREMENTS:
- High school education or Associate degree preferred.
- Experience in an oncology clinic or other medical setting with medical terminology preferred.
- Proficiency with software necessary to perform essential job functions such as medical records and insurance portals.
OTHER:
- In office Monday - Friday, 8am-4pm (7.5 hours/day, 37.5 hours/week)
- Mandatory Annual Continuing Education: Customer Service, Fire and Safety, Confidentiality-HIPAA, Infection Control, Corporate Compliance. Annual Unit Specific Competencies, and all education required by regulatory, accreditation bodies and/or Hancock Regional Hospital.
EQUIPMENT USED: Meditech EMR, insurance portals. Desktop computer provided
ENVIRONMENTAL CONDITIONS: Office setting.
Required
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1 year(s): Medical office experience required; oncology experience preferred. Insurance verification experience required; prior authorization experience preferred.
Required
Required
Preferred
Required
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Thought Provoking: Capable of making others think deeply on a subject
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Dedicated: Devoted to a task or purpose with loyalty or integrity
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Team Player: Works well as a member of a group
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Detail Oriented: Capable of carrying out a given task with all details necessary to get the task done well
Preferred
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Goal Completion: Inspired to perform well by the completion of tasks
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Ability to Make an Impact: Inspired to perform well by the ability to contribute to the success of a project or the organization
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Self-Starter: Inspired to perform without outside help
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.
