Category:

Admin Support

City:

Jackson

State:

Tennessee

Shift:

8 - Day (United States of America)

Job Description Summary:

Under the general direction of the Radiation Oncology Business Manager, this employee is responsible for obtaining, tracking and updating authorizations for all visits, treatments and diagnostic exams provided for KCC radiation oncology patients. This individual assists with coverage for other clerical staff for vacations and/or days off. Employee is subject to call back and overtime as required by the hospital.

ESSENTIAL JOB FUNCTIONS:

• Responsible for obtaining and documenting in Aria and Cerner and Epic all Pre-Authorizations for clinic treatments and visits.
• Develops reports from Aria in order to monitor and track authorizations due for renewal
• Manages all incoming communications and correspondence from third party payors.
• Responsible for assisting with faxes and entering precertification information in Cerner and/or Epic and Aria, and relaying the information to the appropriate staff member.
• Assists with appeals, denials and completes retro review requests.
• Identifies any billing issues and works to correct any issues that inhibit the collection process.
• Responsible for notifying Admissions with any updates regarding guarantor/patient demographic or insurance information.
• Scans all authorization correspondence into Aria/Epic according to set standards and maintains records in a confidential manner.
• Understands Current Procedural Terminology and its relationship with ICD-10 diagnosis coding to assist with pre-certifications.  Needs to be able to reference both manuals as a resource and know how to research issues when necessary.
• Must be able to back up other clinic business office functions including reception, greeting patients, scheduling, answering phone calls and other office functions as needed, as well as providing coverage for vacation and/or days off.
• Performs related responsibilities as required or directed.

JOB SPECIFICATIONS:

  EDUCATION:

• High school graduate with a minimum of two (2) years of business related education preferred.

     LICENSURE, REGISTRATION, CERTIFICATION:

• None required

    EXPERIENCE:

• Prefer prior experience in a clinic office setting obtaining insurance authorizations for services.
• Three to five years of business or medical related customer service experience.

     KNOWLEDGE, SKILLS AND ABILITIES:

• Proficiency in the use of a desktop computer and applications such as the internet, Word, Excel, and Microsoft Outlook are required. Previous experience with an electronic medical record system, such as Cerner helpful but not required.
• Must be able to type a minimum of 30 words per minute accurately, operate a printer, copy machine, fax machine and other office equipment.

NONDISCRIMINATION NOTICE STATEMENT

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, disability, religion, national origin, gender, gender identity, gender expression, marital status, sexual orientation, age, protected veteran status, or any other characteristic protected by law.