Position Highlights:

• Work/life: Monday-Friday 8am-4:30pm. You will find support to help you manage your personal life while building a career.
• Employee-centric: 401(k), health and wellness offerings, monthly employee events, and more.
• Lifestyle: Sandusky was voted “Best Coastal Small Town in America”. You will have the opportunity to enjoy living and working in this growing area along the beautiful shores of Lake Erie.

About Firelands Health:

Our goal at Firelands Health is to be the best & preferred independent healthcare employer for the Sandusky Bay region.

Firelands Health is the area’s largest and most comprehensive resource for quality medical care. We are “big enough to care for you, and small enough to care about you”. We are locally managed and governed as a not-for-profit healthcare facility, serving the counties of Erie, Ottawa, Sandusky, and Huron, covering a regional service area with over 300,000 residents. Our mission is to provide excellent healthcare, promote community wellness, and improve the lives we serve.

Our Core ACE Values: Attitude: We choose to be positive and inclusive every day. Commitment: We are committed to exceed the expectations of those we serve. Enthusiasm: We will work passionately to make a difference.

What You Will Do:

Responsible for performing a variety of duties including but not limited to: coordinating from start to finish internal and external referrals for oncology providers to ensure good continuity of care; obtaining any necessary prior authorizations for visits or procedures related to referrals; training new employees on relevant portions of the referral process and navigating necessary insurance web sites; monitoring for accuracy of patient information, and monitoring for completion of the process; implementing special projects related to the referral and prior authorization process; verifying insurance coverage; obtaining pre-certifications or prior authorizations as needed. Assigned to administrative office but may need to assist in working in other areas of the cancer center.

• Completes required steps for initiating, monitoring progress, and completing referral process, assuring accurate input and tracking of referrals, and communicating with patients and providers as necessary.
• Manages outgoing referrals to specialists, cancer rehabilitation, palliative care, radiology, tertiary care, and other services as needed. Ensures all ordered referrals have been scheduled and coordinates these appointments with the patient.
• Completes all steps of the prior authorization process and communicates outcomes to patients and providers as necessary.
• Provides training to new employees on the referral and prior-authorizations processes.
• Implements special projects related to referrals and prior authorizations, including training and monitoring staff.
• Maintaining passwords and user knowledge of insurance websites and training other staff or employees as needed.
• Work closely with managers and other members of the Operations team to problem solve and implement solutions integral to the referral and prior authorization processes.
• Completes AMB and ACUTE registration for the cancer center. Understands critical communication techniques to obtain accurate and complete patient demographic and financial information.
• Demonstrates understanding of performing patient interview using appropriate techniques in a compassionate, empathetic manner, whether on the phone or in person.
• Utilizes registration software programs to assist registration accuracy including but not limited to address verification and insurance verification.
• Works jointly with University Hospital, Magruder Hospital, Fisher Titus, and The Bellevue Hospital for patient scheduling and information retrieval. Coordinates multi-disciplinary treatment.
• Answers incoming calls with a positive attitude; screens and communicates messages to the appropriate person. Logs patient calls and immediately addresses symptom management calls with nurse through the triage workflow.
• Assist patients with Financial Navigation questions and refer to Financial Navigation staff if applicable.

What You Will Need:

• High School graduate; vocational education or associates degree preferred; Clinical degree or medical ambulatory setting experience preferred.
• Interpersonal: Development and maintenance of effective relationship with medical and administrative staff, patients and families, co-workers and the public. Ability to communicate effectively in writing and verbally with medical and administrative staff, patients and families, co-workers and insurance companies. Skill in preparation and presentation of reports to NCPC management as requested. Ability to remain calm and poised in urgent situations.
• Critical Thinking: Skill in exercising initiative, judgment, problem solving, and decision making. Skill in analysis and interpretation of data, and preparation of reports. Skill in time management and organization. Ability to prioritize and meet deadlines to avoid crises management.
• Knowledge: Organization policies, procedures, systems and objectives. Knowledgeable in medical office procedures and medical terminology with computer and cash handling experience. Governmental regulations and compliance requirements. Computer systems and applications.