Administrative Skills, Clinical Study Publications, Communication Skills, Corporate Compliance, Current Procedural Terminology (CPT), Customer Support/Service, Demographics, Electronic Medical Records, Fax Machines, Fire Safety, HIPAA (Health Insurance Portability and Accountability Act), Health Insurance, Infection Control, Insurance, MEDITECH, Medical Records, Medical Terminology, Medicine, Oncology, Outpatient Care, Patient Assessment, Patient Care Authorizations, Secondary School, Telephone Skills
JOB SPECIFIC CORE COMPETENCIES:
- Demonstrate the ability to verify patient insurance eligibility and benefits.
- Demonstrate the ability to obtain precertification for outpatient procedures with correct CPT and diagnosis codes through appropriate insurance company online, fax, and by telephone.
- Demonstrate the ability to document authorizations in Meditech and link to appropriate appointments.
- Identify and submit appropriate clinical documentation to insurance companies to support authorization requests.
- Demonstrates excellent communication skills with medical staff and patients.
- Ability to check patients in, verify demographic information, answer calls, sort and deliver faxes.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:
- Verify patient insurance eligibility and benefits on all infusion patients by verifying pre-certification note, date range, and number of cycles..
- Obtain pre certifications and authorizations for scans, labs, and infusions as assigned.
- Document authorizations in Meditech and link to appropriate appointments.
- Identify and submit appropriate clinical documentation to insurance companies to support authorization requests.
- Exhibit excellent communication skills with medical staff and patients.
- Check in patients, verify patient demographic information, answer incoming calls, and sort and deliver faxes as needed.
- Follow up on outgoing referrals as needed.
EXPECTED BEHAVIORS:
- Interacts collaboratively with team members
- Ability to maintain composure under stressful situations.
- Possesses a sense of responsibility, initiative, honesty, and confidentiality.
- Maintain satisfactory, regular and predictable attendance by reporting to work as scheduled and keeping unscheduled absences to a minimum.
EDUCATION AND EXPERIENCE REQUIREMENTS:
- High school education or Associate degree preferred.
- Experience in an oncology clinic or other medical setting with medical terminology preferred.
- Proficiency with software necessary to perform essential job functions such as medical records and insurance portals.
OTHER:
- In office Monday - Friday, 8am-4pm (7.5 hours/day, 37.5 hours/week)
- Mandatory Annual Continuing Education: Customer Service, Fire and Safety, Confidentiality-HIPAA, Infection Control, Corporate Compliance. Annual Unit Specific Competencies, and all education required by regulatory, accreditation bodies and/or Hancock Regional Hospital.
EQUIPMENT USED: Meditech EMR, insurance portals. Desktop computer provided
ENVIRONMENTAL CONDITIONS: Office setting.
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Hancock Regional Hospital