Experience Inc. Jobs

Description:

· Reviews, processes and audits the medical necessity for each patient chemotherapy treatment and documentation of regimen relative to pathway adherence. · Communicates with nursing and medical staff to inform them of any restrictions or special requirements in accordance with particular insurance plans. · Provides prompt feedback to physicians and management regarding pathway documentation issues, and payer issues with non-covered chemotherapy drugs. · Updates coding/payer guidelines for clinical staff. · Obtains insurance authorization and pre-certification specifically for chemotherapy services. · Works as a patient advocate and functions as a liaison between the patient and payer to answer reimbursement questions and avoid insurance delays. · Researches additional or alternative resources for non-covered chemotherapy services to prevent payment denials. · Provides a contact list for patients community resources including special programs, drugs and pharmaceutical supplies and financial resources. · Maintains a good working knowledge of chemotherapy authorization requirements for all payers, State and federal regulatory guidelines for coverage and authorization.

Skills:

insurance verification, insurance authorization, insurance administration

Top Skills Details:

insurance verification,insurance authorization

Additional Skills & Qualifications:

BVA: · Authorization experience is a plus, preferably in Oncology · Associates degree in Healthcare, LPN state license and registration preferred · Radiology authorization experience

Experience Level:

Intermediate Level

About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.