PRECERTIFICATION PRIOR AUTH SPEC, CANCER CENTER ADMIN

Job Summary

Responsible for obtaining precertification and/or prior authorization for patients' tests and procedures, ensuring they are covered by insurance before services are rendered. Must obtain authorization by 2:00 p.m. the day prior to the appointment. Uploads authorization numbers and supporting documents into Mosaiq and HIS software upon verification of authorization.

Responsibilities

• Obtain precertification and/or prior authorization for radiologic testing, injections, chemotherapy, and radiation treatments
• Contact patients to reschedule appointments if authorization cannot be obtained
• Review and verify accuracy of information and supporting documents
• Upload authorization numbers, time spans, and supporting documents into Mosaiq and HIS software
• Use Quality Check List (QCL) to monitor authorization requests and expiring authorizations
• Document in Mosaiq as the official medical record, following appropriate guidelines
• Contribute to program development

Requirements

• High school graduate preferred
• Minimum (1) year prior administrative experience in a hospital or medical office setting
• Working knowledge of insurance and managed care
• Excellent computer skills, including PC and Windows literacy and proficiency in Microsoft Office applications
• Prior use of medical office software database preferred
• Excellent communication and interpersonal skills
• Self-motivated, able to manage multiple tasks, meet deadlines, and adapt to various situations
• Flexibility in work schedule to meet accountability expectations for operations and process management

Knowledge, Skills & Abilities

• High school graduate preferred
• Minimum (1) year prior administrative experience or equivalent in a hospital or medical office setting
• Working knowledge of insurance and managed care
• Excellent computer skills, including PC and Windows literacy and proficiency in Microsoft Office applications
• Prior use of medical office software database preferred
• Excellent communication and interpersonal skills
• Self-motivated, able to manage multiple tasks, meet deadlines, and adapt to various situations
• Flexibility in work schedule to meet accountability expectations for operations and process management