Access Coordinator, Oncology And Hematology Infusion (Remote Call Center Agent)
CurrentReview Drug utilization per national guidelines, and maintain a solid working knowledge of insurance and billing requirements related to infusion services and procedures for maximum reimbursement of claims and to minimize financial riskVerify and document patient insurance coverage and coordinate financial support with the practice director and the cancer center social worker team if required.Determines the need, obtains and/or verifies pre-authorizations or referrals of assigned schedules, in collaboration with the ordering physician, for high complexity medications: chemotherapy (Oral and IV), biotherapy and hematologic, prior to the patient's appointment.Work effectively and efficiently with referring physician offices and hospital providers to coordinate patient care.Coordinate with patient financial services to investigate and resolve billing discrepancies/denials.Performs daily operational duties such as scheduling, registration, pre-registration, verification, and authorization for treatments utilizing the Varian (EMR) and Soarian systems.Request referral, track and monitor process ensuring a timely response to the request and follow up interaction with the Patient and their Referring PhysicianInvestigate patient out of pocket costs and available support programs, referring patient account to the Cancer Center Social Worker and/or the CCOH Billing Manager.Reports to providers and billing manager denied requests and follow up with the provider regarding the need for further intervention.
