PRN Patient Service Representative

Patient Services Representative - Part-Time PRN, Remote

Hourly Pay Range: $22-$25

SCOPE: Under direct supervision, prior auth submissions for chemotherapy, oncology and hematology medications, insurance eligibility, obtain chemotherapy/infusion/injection benefits, utilize insurance policies, drug indications for approvals, document final approvals into medical records, scan approval letters, provide coverage for team when out of office.

ESSENTIAL DUTIES AND RESPONSIBILITIES :

- Ensures all regimens are approved using an NCCN, Authorization obtained, or FDA medically necessary indication

-Verifies patient insurance- obtaining in network status, benefits-copay, deductibles, out of pocket, buy and bill allowed, prior auth check, reference number and documentation in EMR

- Looks up cpt codes using online insurance sources available for specific insurance plans

- Submits prior authorizations on available online portals

- Utilizes appropriate forms, fills out all appropriate information, cpt codes, diagnosis codes and medical records to submit requests

-Covers other team members for time off

MINIMUM QUALIFICATIONS:
* High School Diploma or equivalent required. Minimum 1year medical office experience highly desired.
* Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
* Must successfully complete required e-learning courses within 90 days of occupying position.
* Ability to handle and prioritize work in a fast-paced environment and be able to multitask.

COMPETENCIES NEEDED:
* Knowledge of medical terminology.
* Previous knowledge of Electronic Medical Records highly desired.
* Previous Oncology experience highly desired.
* Proficiency with computer systems and Microsoft (Outlook, Office Word, and Excel) highly desired.
* Adaptability: Handles day to day work challenges confidently; is willing and able to adjust to multiple demands, shifting priorities; demonstrates flexibility.
* Commits to Quality: Emphasizes the need to deliver quality products and/or services to patients, families as well as physicians and other staff members.