Kettering Health Network

Patient Access Representative - Cancer Center - Part-Time - Days

Posted Date 3 months ago(3/23/2022 1:19 PM)
Job ID
2022-35443
Job Category
Patient Financial Services
Job Type
Part-Time
Shift
First Shift
# of Openings
2
FTE
40 Hours Per Pay Period/FTE 0.50

Overview

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Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. We are committed to transforming the health care experience with high-quality care for every stage of life. Our service-oriented mission is in action every day, whether it’s by providing care in our facilities, training the next generation of health care professionals, or serving others through international outreach.

 

Our MissionOur VisionOur Values

Responsibilities & Requirements

This position is responsible for the authorizations for all chemotherapy/infusion services at Kettering Cancer Care. This role will obtain accurate and timely decisions from payers regarding authorizations of chemotherapy, infusion, injection therapy and any other procedure requiring authorization on the Grandview infusion floor.  This position requires excellent time management and organizational skills as well as the ability to provide clear and concise communication, both verbally and written. This position is empowered to approve, pend or deny services for our population of patients according to policy. This position requires strong knowledge of ICD9/10 diagnosis codes as well as CPT codes

The employee communicates with nursing and medical staff to inform them of any restrictions or special requirements in accordance with insurance plans. He/she provides prompt feedback to physicians and management regarding any payer issues with non-covered chemotherapy/infusion drugs. He/she uses the EPIC/Beacon work que and referral entry to maintain all new authorizations and expiring authorizations. 

 

Job Requirements:

  • High School diploma required. 
  • Complies with patient confidentiality laws and regulations
  • Minimum one year oncology experience, medical terminology knowledge and strong computer skills required. Attention to detail, ability to discuss delicate matters in pleasant and professional manner required.
  • He/she maintains a good working knowledge of chemotherapy authorization requirements for all payers, State and federal regulatory guidelines for coverage and authorization.

Preferred Qualifications

Preferred Qualifications:

  • A.D. in Business or health related field preferred.
  • Oncology coding and billing experience preferred.

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