Oncology Authorization Specialist

Silver Cross Hospital is an extraordinary place to work. We're known for our culture of excellence and delivery of unrivaled experiences for our patients, their families, the communities we serve.

and for each other. Come join us! It's the way you want to be treated.

Position Summary : Responsibilities :

Responsibilities : A uthorizations :

A uthorizations :

• Review work queues to identify patients with treatment plan orders
• Effectively screen for compliance with payer requirements for medical necessity and precertification
• Record authorization number and relevant details in Epic in the appropriate location
• Use screening software to determine whether services being provided meet third-party requirements for payment.
• Contact physicians as necessary for additional clinical information, initiate Medicare ABN processes as appropriate
• Explains payer policies and financial responsibility to patients within the revenue cycle to assist in meeting other internal, regulatory and payer requirements
• Documents financial expectations of payer and medical necessity verification.
• Possess in-depth knowledge of Medicare, Medicaid, PPO, HMO, and other third-party billing requirements
• Notifies nursing staff and leadership of any delays / denials in obtaining authorization
• Facilitates peer-to-peer conversations
• Enters inpatient Provider charges as needed

Required Qualifications :

• High School Graduate or equivalent
• In-depth knowledge of Medicare, Medicaid, PPO, HMO, and other third-party billing requirements
• Experience with authorizations and / or Oncology preferred
• Ability to speak English clearly and fluently
• Basic computer skills Excellent communication customer service skills

Work Shift Details :

Days, Monday - Friday, No weekends, No Holidays

Department : CANCER CENTER

CANCER CENTER