Chemotherapy Prior Authorization & Verification

Chemotherapy Prior Authorization & Verification Houston Cancer Treatment Centers - 4.4 Houston, TX Job Details Full-time $15 - $17 an hour 1 day ago Benefits Health insurance Paid time off Qualifications Medical office experience HIPAA Health information regulatory compliance Organizational skills Health information management Clinical confidentiality policies Document management Managing patient records Medical terminology Full Job Description Job Summary We are seeking a dedicated and detail-oriented Chemotherapy Prior Authorization & Verification Specialist to join our healthcare team. In this vital role, you will be responsible for managing the authorization process for chemotherapy treatments, verifying insurance coverage, and ensuring compliance with healthcare regulations. Your proactive approach will help streamline patient care, facilitate timely treatment approvals, and maintain accurate medical records. This position offers an exciting opportunity to contribute to patient outcomes by coordinating with insurance providers, healthcare providers, and patients to ensure seamless treatment authorization. Responsibilities Obtain prior authorization for chemotherapy treatments by reviewing medical documentation and submitting necessary requests to insurance companies. Verify patient insurance coverage accurately using managed care systems and insurance portals. Communicate effectively with insurance providers to clarify coverage details, authorization statuses, and resolve any discrepancies promptly. Maintain comprehensive records of all authorization requests, approvals, denials, and related correspondence in accordance with HIPAA regulations. Collaborate with medical offices to gather required documentation such as CPT (Current Procedural Terminology) codes, ICD (International Classification of Diseases) codes (ICD-9 and ICD-10), and other relevant medical coding information. Ensure compliance with all healthcare privacy standards by adhering to HIPAA guidelines during data handling and communication. Assist in reviewing medical records for accuracy and completeness related to chemotherapy procedures and insurance claims. Support the billing team by providing accurate coding information and verifying insurance benefits prior to treatment. Qualifications Proven experience in managed care, medical office administration, or healthcare insurance verification. Strong knowledge of medical terminology, medical records management, and medical coding including CPT, ICD-9, ICD-10, and ICD coding systems. Familiarity with insurance verification processes within healthcare or dental office environments is highly desirable. Excellent organizational skills with attention to detail in managing multiple authorization requests simultaneously. Ability to communicate effectively with insurance companies, healthcare providers, and patients while maintaining professionalism and confidentiality. Knowledge of HIPAA regulations to ensure patient privacy and data security are upheld at all times. Prior experience working with medical office software or electronic health record (EHR) systems is preferred. Ability to adapt quickly in a fast-paced environment while maintaining accuracy and compliance standards. Join our team as a Chemotherapy Prior Authorization & Verification Specialist and play a crucial role in delivering timely cancer care! Your expertise will help ensure patients receive their treatments without delay while maintaining the highest standards of privacy and accuracy in healthcare administration.

Job Type:

Full-time Pay:

$15.00 - $17.00 per hour

Benefits:

Health insurance Paid time off

Work Location:

In person