Job Details

Oncology Authorization Rep, Miami Cancer Institute, FT, 10:30a-7p

Job: Insurance
Facility: Miami Cancer Institute at Baptist Health,
Primary Location: Miami
Job Schedule: Full-time
Job ID: 82147

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About Baptist Health South Florida:

Baptist Health South Florida ranked #25 on the list of 2018 Fortune 100 Best Companies to Work For! This is the 18th time Baptist Health has been named to the prestigious list and was listed #1 in diversity overall , #2 in the state of Florida, and #3 in healthcare organizations on the list. We have also been recognized for being among the best healthcare providers in the nation by U.S. News & World Reports in its 2017-2018 Best Hospitals report.

Baptist Health South Florida is the region’s largest not-for-profit healthcare organization with more than 19,500 employees working across ten hospital campuses, more than 40 physician practices and 50 outpatient and urgent care facilities throughout Monroe, Miami-Dade, Broward and Palm Beach counties. Everything we do at Baptist Health, we do to the best of our ability. That includes supporting our team with extensive training programs, millions of dollars in tuition assistance, comprehensive benefits and more. Working within our award-winning culture means getting the respect and support you need to do your best work ever. Find out why this is the best place to be your best!

Job Description:

Job Function: Essential Job Function – Oncology Authorization Rep – Applies medical information and complex data entry in order to process requests for chemotherapy accurately and completely. Must interpret NCCN guidelines for supportive care and medical necessity. Assist in the back end collections if there is any withholding of payment because of an authorization issue. Assist collectors as needed with questions in regard to patient authorizations. Answer patient and physician office calls in regard to any questions about authorizations or treatments. Assists leadership in the evaluation of departmental processes, recommends process improvements, and provides learning mechanisms for the staff. Trends data and provides analytical support. Communicates to MDs, Nurses, Financial Counselors, Management, and patients of any issues or denials. Follow insurance company guidelines and procedure for authorization requests to ensure timely and accurate authorizations. Check and follow up on any pending authorizations. Maintains knowledge in AJCC staging and pathology types as well as regimen dosing and frequency of chemotherapy. Remains current with changes in the healthcare industry by participating in continuing education courses. Shares information with team members, and leadership. Coordinates education opportunities for team members and acts as team resource. Abides by all HIPAA regulations. Is confidential and accesses all patient information only as needed for business and as appropriate by policy guidelines. Reviews patient reports in advance identifies patients that require authorizations for treatment and/or office visits. Reviews patient treatment plans for authorizations and requests as needed. Works with management to ensure the application of appropriate internal controls, timeliness, accuracy. Engages leadership to resolve issues timely.

Qualifications:

Degrees: High School,Cert,GED,Trn,Exper Additional Qualifications: Working with insurance companies and patient authorizations, preferably in the oncology field. Must have proficient computer skills including, EMR and electronic medical management system, outlook and MS Word, ARIA & Centricity proficiency preferred. Education and training in medical terminology preferred. Minimum Required Experience: 3 Years

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