Medical Assistant Oncology - Authorization Specialist

Silver Cross Hospital • Full-time • New Lenox, Illinois, United States • 1m ago

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:

Authorizations:

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
CPR and PhlebotomyCertified MA preferred
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 skillsExcellent communication customer service skills

Work Shift Details:

Days, Monday - Friday, No weekends, No Holidays

Department:

CANCER CENTER

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