Authorizations Team Lead - Oncology, Santa Monica

Description

In this role, you will serve as the Lead Authorizations Coordinator for FPG / Hematology-Oncology. The incumbent is expected to use in-depth knowledge of Hematology / Oncology standard of care and research authorizations clearance to train all community practice authorization coordinators.

The incumbent will work closely with the Manager and Supervisor to ensure appropriate initial training is provided to all new hires as well as provide ongoing training to existing staff members.

The incumbent will serve as a resource for all authorization coordinators and community practice managers.

The following information provides an overview of the skills, qualities, and qualifications needed for this role.

The incumbent will possess knowledge of verifying insurance benefits for requested procedures and medications, confirming and obtaining appropriate authorization for office visits, procedures, and chemotherapy.

In addition to the lead duties, the incumbent is expected to handle the daily tasks of Authorizations coordination, obtaining authorization for and scheduling chemotherapy, injections, and procedures within the office, at UCLA facilities, and at outside facilities.

Provide a high level of customer service.

Major duties include :

• Train new and existing clinic schedulers in all Hematology / Oncology community practices.
• Verify insurance benefits for requested procedures and medications.
• Confirm and obtain appropriate authorization for office visits, procedures, chemotherapy, etc.
• Special projects as assigned.

Salary range : $25.95 / hr - $54.50 / hr

Qualifications

Required :

• In-depth working knowledge of insurance authorization and verification process for major medical insurance plans.
• Knowledge of oncology CPT and ICD-10 codes and medical office procedures.
• Experience with varied computer software and hardware including word processing, knowledge of Microsoft Word, Excel, Outlook, the internet and with an EMR system.
• Typing skills to prepare forms and correspondence with speed and accuracy.
• Possesses strong customer service skills to promote pleasant and effective interactions with patients, staff, and physicians.
• Knowledge of billing and medical office procedures.
• Ability to set priorities and complete assignments in a timely manner under minimal supervision.
• Advanced organizational skills to ensure a workable, efficient workspace and accomplish established objectives.
• Skill in adapting to and implementing frequently changing procedures.
• Working knowledge of third party payor verification terminology to determine benefit eligibility and interpretation of coverage.
• Knowledge of State and Federal programs to ensure reimbursement from Medicare, Medi-Cal, or other sponsoring agencies.
• Skill in analyzing information, problems, situations, practices, and procedures to recognize alternatives and provide solutions.
• Ability to problem-solve with other members of the clinic team while maintaining cooperative working relationships with administrators, physicians, peers, and the public.
• Skill in recognizing an emergency or high priority situation and taking appropriate and immediate action.
• Demonstrated ability to maintain composure when confronted by difficult situations and to respond professionally.
• Skill in speaking clearly and using appropriate grammar.
• Ability to work as part of a team, maintaining confidentiality in all assignments, and showing initiative in identifying and solving problems as they occur.

Preferred :

Knowledge of patient assistance programs.

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