Intake Assistant/Prior Authorization

Dearborn

Busy outpatient hematology oncology office in Dearborn looking for an experienced Prior Authorization/Intake Assistant.

Essential Duties:

Conducts prior authorization for all pre-medications, primary chemotherapy drugs and supportive drugs. This involves research into the Medicare system, utilizing off label drug compendiums and direct authorization work with patient primary and secondary insurers. Will require close interaction with Department physicians, mid-level practitioners, nurses.
Perform insurance verification in a timely manner for initial and subsequent pre-authorizations with all third-party payers for chemotherapy.
Obtain appropriate clinical documentation to ensure accurate indications from EMR prior to completion of third party prior authorizations.
Maintaining up-to-date knowledge of requirements for enrolling patients in assistance programs:
- Obtains initial and subsequent insurance authorization and pre-certification for chemotherapy services, surgeries, and imaging.
- Researches additional or alternative resources for non-covered services to prevent payment denials.
- Maintains a close working relationship with site Patient Financial Counselor.
- Communicates with clinical staff, PFC, and management restrictions or unique requirements for insurance plans.
- Maintains a current working knowledge of authorization requirements for all payers, and of state and federal regulatory guidelines.
- Assists in maintaining manuals, logs and other required documentation.
- Demonstrates an understanding of patient confidentiality to protect the patient and the clinic/corporation.
- Follows policies and procedures to contribute to the efficiency of the front office.
- Covers for and assists with other front office functions as requested.
- Other duties as may be assigned.

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.

Education / Training: High school diploma or equivalent.
Work Experience: A minimum of (3) years of medical business office experience with insurance procedures and patient interaction. Additional clinical background preferred.
Oncology prior auth experience preferred.
Insurance prior authorization: 1-2 years experience required.
Knowledge of medical terminology.
Excellent communication skills, both written and verbal.
Excellent computer skills to include Microsoft Office Suite, EHR/EMR and insurance portals.

For more information or to apply:

Please email resume to bettinna.signori@beaumont.org.

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