The US Oncology Network · 1 day ago
Insurance Reviewer - Clinical
Eugene, OR
Full-time
Onsite
Mid Level
$22.01/hr - $31/hr
3+ years expThe US Oncology Network is looking for an Insurance Reviewer to support patients receiving necessary testing and treatment by navigating insurance portals and obtaining appropriate authorizations. The role focuses on authorizations for various treatments and requires effective communication with medical staff and adherence to regulatory guidelines.
CommunitiesHealth CareMedicalOncologyTest and Measurement
Responsibilities
Reviews, processes and audits the medical necessity for treatments including radiation oncology, gynecologic surgery, genetic lab testing, imaging, and chemotherapy treatment for each patient. Documentation of regimen related to pathway adherence and payer guidelines
Communicate with nursing, physician, pharmacists 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. Tracks pathways and performs various other business office functions on an as needed basis
Obtains insurance authorization and pre-certification for various oncology & hematology related services
Maintains a good working knowledge of chemotherapy authorization requirements for all payers, State and federal regulatory guidelines for coverage and authorization. Adheres to confidentiality, state, federal, and HIPAA laws and guidelines with regards to patient’s records
Other duties as requested or assigned
Qualification
Required
High school degree or equivalent
Minimum three (3) years of prior authorization experience required
Preferred
Revenue cycle experience preferred
Benefits
M/D/V
Life Ins.
401(k)
Company
The US Oncology Network
Every day, The US Oncology Network helps approximately 3,300 providers deliver value-based, integrated care for patients—close to home.
10001+ employees
H1B Sponsorship
The US Oncology Network has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2023 (1)
Funding
Current Stage
Late StageTotal Funding
unknown2010-12-30Acquired
Leadership Team
R. Steve Paulson
National Policy Board Executive Committee
Recent News
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