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Pre-Certification Analyst Surgery/VA

Highlands Oncology Group

Highlands Oncology Group

IT
Springdale, AR, USA
Posted on Saturday, June 29, 2024

Pre-Certification Analyst Surgery/VA

Springdale, AR 72762

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Skills

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Education

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Job details

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Job type

  • Full-time

Shift and schedule

  • Monday to Friday

Location

Springdale, AR 72762

Benefits
Pulled from the full job description

  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Disability insurance
  • Employee assistance program
  • Health insurance
  • Health savings account

Full job description

Come join our world class team and help us bring cancer treatment HOME!

Highlands Oncology began in 1996 with three physicians and a desire to change the face of oncology care in our community. Our founding physicians knew that patients do better at home, in the community where they live and work, and where their support system is already in place. In furthering that goal, Highlands has grown with the region from a single location 26 years ago, to 6 locations in Northwest and Northcentral Arkansas today employing more than 700 diverse team members.

As Northwest Arkansas continues to grow, so must the services and providers available in the region. Highlands Oncology is committed to remaining on the cutting edge to ensure our community has access to the very best cancer care. What we have is something quite unique right here in our own backyard with a caring multidisciplinary team focused on treating patients as family.

Job Title: Pre-Certification Analyst – Surgery/VA

Reports To: Pre-Certification Supervisor

Location: Northwest Arkansas – Depending on the position, employees may be asked to move locations from time to time based on clinic and patient needs.

FLSA: Non-Exempt/Hourly

Job Summary:

The Pre-Certification Analyst for surgical oncology and VA services obtains prior authorizations for services as applicable. Fills out forms online or on paper; retrieves and submits records as needed to obtain authorizations. Works with patients, insurance companies, and clinical staff members.

Job Duties / Responsibilities: Including, but not limited to, the following:

  • Review of surgery schedules for Benton County Clinic, North Hills Clinic, Mountain Home Clinic, and Parkway Clinic daily to determine the insurances that require prior authorization for upcoming procedures/surgeries.
  • Answers and resolves incoming calls regarding STAT and add-on requests.
  • Prompt obtainment of authorization(s) for any urgent add-on requests.
  • Maintain accurate and current authorization(s) information in OncoEMR and G4.
  • Work closely with surgical department and hospital personnel to determine what date requires review to guarantee all authorizations are obtained in a timely manner.
  • Communicates with nursing and medical staff to inform them of any restrictions or special requirements in accordance with specific insurance plans.
  • Work closely with the insurance verification team to ensure insurance coverage is up to date.
  • Maintain a professional relationship with physician/nurses addressing questions, concerns regarding imaging orders/diagnoses.
  • Set up peer-to-peer review as requested.
  • Maintain a good working relationship with outside referring providers and staff.
  • Maintain patient/clinic confidentiality.
  • Ability to cover positions for other prior authorizations, as designated.
  • Maintain patient/clinic confidentiality.
  • Maintain pleasant/helpful attitude towards patients and staff.
  • Perform all related duties as required by Revenue Cycle Manager(s), Business Office Director, CFO, and CEO.

Required Skills/Abilities:

  • Knowledge of g4/PM System & OncoEMR.
  • Proficient in computer skills.
  • Communicates clearly and concisely.
  • Ability to work in a fast-paced environment.
  • Ability to work independently and as part of a team.
  • Ability to maintain good working relationships.
  • Demonstrates attention to detail.
  • Strong knowledge of medical terminology.
  • Demonstrates professionalism in appearance/dress code.
  • Knowledge of ICD-10-CM, HCPCS, and CPT codes.

Certifications/Licenses/Education/or Experience in a related field:

  • High School Diploma or equivalent.
  • Minimum of 1-2 years of medical office experience, preferred.
  • Prior authorization experience, preferred.

Physical Requirements:

  • Will require extensive desk use and computer use with long periods of sitting at a workstation.
  • Light lifting may be required of up to 25 pounds regarding normal office equipment and supplies.
  • Light to moderate walking in an office environment.

Job Type: Full-time

Benefits:

  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Disability insurance
  • Employee assistance program
  • Health insurance
  • Health savings account
  • Life insurance
  • Paid time off
  • Referral program
  • Retirement plan
  • Vision insurance
  • Wellness program

Weekly day range:

  • Monday to Friday

Experience:

  • Insurance verification: 1 year (Preferred)
  • Medical billing: 1 year (Preferred)

Ability to Commute:

  • Springdale, AR 72762 (Required)

Ability to Relocate:

  • Springdale, AR 72762: Relocate before starting work (Required)

Work Location: In person

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