|Location:||Midwestern Regional Medical Center|
|Department:||332302 Pre certification Specialist|
|Employment Status:||Full time|
|Shift Hours / Days:||Mon - Fri days|
|Hours / Pay Period:||80|
|Job Function:||Support Services|
We Fight Cancer: Care That Never Quits®
Cancer Treatment Centers of America® (CTCA®) delivers an extraordinary patient experience we call Patient Empowered Care®. We deliver state-of-the-art, high quality care through an integrative model where a team of experts puts patients at the center of their own care. Every day, you will help patients win the fight against cancer. Every day is challenging and rewarding beyond your imagination.
A Culture of Teamwork, Empowerment & Development
CTCA provides Stakeholders with exceptional support and easy access to a wide range of tools and resources they need to bring the best of themselves, every day. Our benefits, wellness, and compensation programs lead the market. Imagine access to your own personal health coach! We also provide extensive training and career development opportunities that encourage professional and personal growth—it is a point of pride. We empower our Stakeholders to deliver the highest standard of care, which we call the Mother Standard®.
The Authorization Specialist provides pertinent information requested from insurance companies and documents authorization details obtained from insurance companies into appropriate database. If the functions of this role are not performed timely and accurately the outcome may have a direct impact on the collectability of account balances and patient satisfaction. The Authorization Specialist will make requests for peer to peer reviews as necessary to obtain authorizations and approvals on certain chemotherapy regimens and testing. At all times follows department guidelines and procedure SWI for of the pre-certification/authorization process: Confirms and documents information regarding all patients' pertinent admission information (i.e., doctor's orders, plan of treatment/surgery, etc.) and initiates the documentation from the patient's insurance company. After completion of the precertification/authorization confirmation, the Specialist begins the paper trail/electronic process by which information is provided to oncology patient services and case management. Both oncology and medical/surgical patients require the same pre-certification/authorization confirmation.
Minimum of associate's degree in business, healthcare or equivalent is desired; otherwise a minimum 3 years experience in hospital admissions/patient access, registration, business office, financial counseling and/or insurance related field
Strong written and verbal communication skills
Medical Terminology use and understanding is required, CPT/ICD9 Coding is preferred
Insurance Terminology use and understanding is required
Basic typing/keyboard skills
Professional telephone manners are essential
Self-starter with exemplary attendance record and strong analytical and organizational skills
Must have experience with Microsoft Outlook, Basic Computer Skills, and Basic Office Equipment
A solid knowledge base regarding: regulatory compliance requirements and insurance company requirements.
A solid knowledge base regarding: HIPAA, FMLA, COBRA, Patient Rights, Compliance and other privacy and security laws as applicable
A solid knowledge base regarding: EMTALA and all hospital policies.
A solid knowledge base regarding: Medicare and Medicaid
The Best Place to Work
We call ourselves Stakeholders because we all have a stake in the care and success of every patient. Today, CTCA Stakeholders deliver healing and hope to patients fighting complex and advanced cancer in Atlanta, GA, Chicago, IL, Philadelphia, PA, Phoenix, AZ and Tulsa, OK. Each of our hospitals earned a Best Place to Work distinction and receives numerous accreditations that celebrate our culture of clinical quality, innovation, high performance and wellness.
Beyond The Resume, What We Look For
We select people with talent—people who thrive in an environment of continuous improvement. We are creative and resourceful problem solvers. We are inventors and innovators. As a CTCA Stakeholder, you make the difference in the life of a patient.
Do you see yourself working with a passionate team in a dynamic, high growth environment? Visit www.cancercenter.com/careers to begin your journey.
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