Precertification Anaylst (Human Resources)
Join a world class team and help to 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. Dr. Malcolm Hayward, Dr. Dan Bradford, and Dr. Thad Beck 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 750 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 like family.
Job Summary: The Precertification Analyst for imaging 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:
Review of imaging schedules for Benton County Clinic, North Hills Clinic, and Parkway Clinic daily to determine the insurances that require prior authorization for imaging.
Answers and resolves incoming calls regarding STAT 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 imaging 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 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 Outside Treatments/Genetic Testing/In-patient Authorizations, as designated.
Maintain pleasant/helpful attitude towards patients and staff.
Perform all related duties as required by the Precertification Supervisor, Revenue Cycle Manager, and Business Office Director.
