Outside Scheduler/Insurance Reviewer Sr-Remote

Why Consider This Job Opportunity

• Competitive benefits package including Medical, Dental, Vision, Life Insurance, and disability coverage
• Generous PTO program and 401k plan with company match
• Wellness program that rewards healthy lifestyle choices
• Opportunities for career advancement and training within the organization
• Remote work flexibility, allowing for a better work-life balance
• Chance to contribute to a mission-driven organization focused on improving cancer care

What To Expect (Job Responsibilities)

• Schedule physician referrals and outside testing as directed, ensuring timely communication with patients
• Review and process medical necessity for chemotherapy treatments and maintain documentation for compliance
• Obtain insurance authorizations and pre-certifications for chemotherapy services, acting as a patient advocate
• Research alternative resources for non-covered chemotherapy services to prevent payment denials
• Maintain knowledge of chemotherapy authorization requirements and adhere to confidentiality and regulatory guidelines

What Is Required (Qualifications)

• A high school degree or equivalent; an Associate's degree in Healthcare, LPN state license, and registration preferred
• A minimum of three (3) years in medical insurance verification and authorization, along with two (2) years in clinical review
• Strong technical knowledge of the profession and industry standards
• Excellent judgment and decision-making abilities in uncertain conditions
• Ability to adapt to shifting priorities and handle work challenges effectively

How To Stand Out (Preferred Qualifications)

• Experience in oncology or with chemotherapy services
• Familiarity with state and federal regulatory guidelines for healthcare coverage
• Strong organizational skills and ability to manage multiple tasks efficiently
• Previous experience in patient advocacy or liaison roles
• Proficiency in using office equipment and software related to patient care