Drug Authorization Specialist

Oneoncology - Grand Rapids, MI

Full-time

Hybrid - Grand Rapids, MI

Hospitals

About the position

The Drug Authorization Specialist plays a crucial role in ensuring that patients receive the necessary pre-authorizations for their treatments by acting as a liaison between clinical staff, physicians, and patient accounting. This position is essential for navigating insurance requirements and facilitating communication regarding drug coverage and financial responsibilities, ultimately supporting the mission of improving cancer care for patients.

Responsibilities

• Obtain pre-authorizations for Physician Orders as required by the patient's insurance carrier.
• Communicate with physician/clinical staff on reimbursement issues and/or pre-certification requirements by the patient's insurance carriers.
• Coordinate and communicate information required or requested by Patient Accounting within the mandated timeframe.
• Ensure up-to-date documentation on patient's accounts in Electronic Medical Record and Patient Management on follow up or ongoing drug authorizations.
• Keep current on drug and insurance carrier requirements.
• Educate patients about their insurance coverage and benefits, including deductible, copay, coinsurance and estimated out of pocket costs as needed.
• Determine patient financial ability to pay and provide financial counseling services regarding payment arrangements and financial assistance for uninsured and underinsured patients by phone or in person as needed.
• Maintain continued authorizations of drugs ensuring that all treatment dates are covered for reimbursement.
• Resolve items in task management related to drug authorization issues.

Requirements

• High School diploma or equivalent required.
• Medical insurance background.
• Must be willing and able to lift up to 25 pounds.
• Must be willing and able to travel to satellite clinics when necessary.
• Excellent written and verbal communication skills.
• Excellent customer service skills.
• Knowledge of clinic office procedures, medical practice and medical terminology.
• Ability to recognize, evaluate and solve problems.
• Strong organizational skills and attention to detail.
• Proficient in the use of end-user computer applications regarding productivity (MS Word, Excel, Outlook), database and patient scheduling and other medical information systems.

Benefits

• Health insurance