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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in validating and obtaining authorizations for Oncology Radiation/Infusion, while maintaining knowledge of insurance requirements and healthcare regulatory guidelines. Exhibits strong leadership capabilities and excellent customer service skills in a fast-paced, high-volume environment.
Highest-signal resume keywords
Authorization ValidationOncology Radiation/Infusion KnowledgeHealthcare Regulatory GuidelinesCustomer Service SkillsLeadership Experience
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
CPT CodingICD-10 CodingAuthorization/Pre-CertificationMedical TerminologyBasic Mathematical Calculations
Soft Skills
Detail OrientedOrganizedTeam PlayerCompassionateInterpersonal Communication
Tools & Technologies
Microsoft OfficeEMR Applications
Certifications & Qualifications
Patient Access Training CoursePrior Authorization On-Demand Webinars
Industry Keywords
HIPAAAHCAEMTALAMedicare Coverage StructureMedical Necessity Compliance
About the role
Key responsibilities & impact- Serve as a preceptor for new hires.
- Request, follow up on, obtain, and validate authorizations, referrals, and notifications with appropriate CPT and ICD-10 codes within appropriate timelines for Oncology Radiation/Infusion.
- Work in a call center-type environment and meet individual quality metrics.
- Coordinate patient flow and timely processing.
- Maintain knowledge and deploy practices used within the department, physician practice, and hospital to address patient questions or concerns.
- Serve as an authorization resource and take on a leadership role in the absence of a Manager/Supervisor.
- Maintain knowledge of insurance requirements, BHSF pricing, financial assistance options, and BHSF Revenue Cycle operations.
- Assist in supporting go-lives and departmental initiatives.
- Participate in departmental committees/champion opportunities.
- Provide professional, compassionate, and friendly service to patients of all ages, families, employees, physicians, and community members.
Requirements
What you’ll need- High School, Cert, GED, Trn, Exper.
- Minimum required experience: 4 years
- For internal staff: A min of 4 yrs exp in validating/obtaining authorizations.
- Meets/exceeds all Individual Performance Standards for at least the most recent 12 months.
- Exceeds department KPIs.
- Assist co-workers and precepts new hires.
- Cross trained in multiple areas/product lines/practices to substitute all staff positions as needed.
- For external staff: AA Degree preferred with 4 yrs exp in validating/obtaining authorizations or 5 yrs exp in lieu of degree.
- Prior Authorization On-Demand Webinars to be completed within 3 months of hire, & updated yearly education required.
- Complete & pass the Patient Access training course.
- Ability to work in a high volume, fast-paced work environment and perform basic mathematical calculations.
- Detail oriented, organized, team player, compassionate, excellent customer service and interpersonal communication skills.
- Desired: Authorization guidelines for Oncology Radiation/Infusion knowledge.
- Leadership experience preferred.
- Knowledge of healthcare regulatory guidelines including HIPAA, AHCA, EMTALA, Medicare coverage structure, and medical necessity compliance guidelines.
- Working knowledge of insurance contracts and authorization/pre-certifications.
- Microsoft Office products and EMR applications.
- Knowledge of medical terminology.
- Bilingual English, Spanish/Creole preferred.
Benefits
Comp & perks- Career growth and development opportunities, with clear pathways and ongoing support
- Comprehensive health and wellness resources
- A wellness program that can help employees eliminate their medical plan deductible
- Tuition reimbursement
- And so much more