Biotech and Pharmaceutical, Cancer, Clinical Data, Clinical Information, Clinical Research, Clinical Support, Communication Skills, Cross-Functional, Electronic Medical Records, Employee Assistance Plan, Healthcare Providers, Healthcare Reimbursement, Hematology, High School Diploma, Insurance, Life Insurance, Medical Office, Medical Records, Medical Terminology, Medical Treatment, Medicine, Microsoft Excel, Microsoft Office, Microsoft Outlook, Microsoft Word, Nursing, Oncology, Organizational Skills, Patient Admissions, Patient Care, Patient Care Denials, Physical Demands, Plan Meetings, Presentation/Verbal Skills, Radiation Therapy, Reimbursement, Treatment Plan, Writing Skills
Employment Type: Full-Time
In-Office Position
10604 Southwest Highway
Chicago Ridge, Illinois 60415
Join the Affiliated Oncologists team as a Referral Coordinator!
Affiliated Oncologists has been a trusted leader in cancer care for over 50 years in Chicago’s Southland. Our team focuses on each patient’s needs, guiding them through their journey from diagnosis to survivorship.
We offer personalized treatment plans using the latest cancer treatments, including access to clinical research trials. Our multidisciplinary team includes doctors and advanced practice providers specializing in medical oncology, hematology, radiation oncology, gynecologic oncology, and gynecologic surgery.
SCOPE:
Coordinates and communicates all patient insurance and payment information. Updates and disseminates all clinical supportive data to appropriate staff to maximize reimbursement and avoid insurance delays. Supports and adheres to the US Oncology Compliance Program, to include the Code of Ethics and Business Standards.
Responsibilities:
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Reviews the medical necessity for each patient activity and service, including radiological and specialty referrals and daily hospital admissions for appropriateness. Coordinates with Patient Service Coordinators to reschedule appointments as necessary.
- Obtains insurance authorization and referrals for services.
- Works to prevent payment denials and delays through understanding of payment plans and contracts for patient services involving clinical pathways.
- Works as a patient advocate and functions as a liaison between the patient, providers, and payor to answer insurance related questions.
- Updates and disseminates all clinical supportive data to maximize reimbursement and avoid insurance delays. Researches additional or alternative resources for non-covered services.
- Provides clinical updates to payors and promptly communicates appropriate information prior to patient insurance reviews.
- Provides clinical and financial information to patients to assist with insurance and payment coordination.
- Clarifies clinical policies and procedures and medical records information to non-medical staff.
- Communicates with nursing and medical staff to inform them of any restrictions or special requirements in accordance with particular insurance plans.
- As necessary, assists patients with community resources including special programs, drugs and pharmaceutical supplies and financial resources.
- Other duties as assigned.
Qualifications:
MINIMUM QUALIFICATIONS:
- High school graduate or equivalent required.
- Three years office experience, preferably in a medical office setting, strongly preferred.
- Previous experience in the oncology field preferred.
- Experience with Electronic Medical Records (EMR) strongly preferred.
- Experience with insurance portals strongly preferred.
- Knowledge of medical terminology required.
- Excellent communication skills, written and verbal required.
- Proficiency in Microsoft Office (Outlook, Word, Excel) required.
PHYSICAL DEMANDS:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit and use hands to finger, handle, or feel. The employee is occasionally required to stand, walk, and reach with hands and arms. The employee must occasionally lift and/or move up to 30 pounds. Requires vision and hearing corrected to normal ranges.
WORK ENVIRONMENT:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Work is performed in an office environment and involves frequent interaction with patients, clinical and business office staff and payors.
Benefits Included in this Position
- Medical
- Healthcare Reimbursement Accounts (HRCA)
- Health Savings Accounts (HAS)
- Dental
- Vision
- Life Insurance
- Short-Term Disability (STD)
- Long-Term Disability (LTD)
- Employee Assistance Program (EAP)
- Commuter Benefits
- 401(k)
- Wellness Program
- Paid Time Off
Salary Range:
$19.00 - $26.00 per hour