What are the responsibilities and job description for the Authorization Specialist position at New York Cancer & Blood Specialists?
Authorization Specialist
Ridge, NY
Hours: Monday-Friday
Why Join Us?
At New York Cancer & Blood Specialists (NYCBS), we create an environment where dedicated professionals can thrive. Our team of expert oncologists, hematologists, and compassionate staff work across numerous locations with one shared mission: conquering cancer close to home. Through cutting-edge treatments, innovative research, and a patient-centered philosophy, we are redefining what’s possible in the fight against cancer and blood disorders. Join our growing organization and help us bring healing, hope, and advanced care to the communities we proudly serve.
In this role, you will:
Starting:$26/hr based on experience and education
Benefits: Health Insurance on day 1, Dental, Vision, Life Insurance, Short- and Long-term disability, 401k Plan, generous PTO, 8 paid holidays (2 floating)
Join us at NYCBS, where we are making strides in healthcare through innovative and compassionate care.
Visit our website at: Nycancer.com
Follow us on Facebook: NYCBS on Facebook
*New York Cancer and Blood Specialists is an Equal Opportunity Employer.*
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2zejrsfsYI
Ridge, NY
Hours: Monday-Friday
Why Join Us?
At New York Cancer & Blood Specialists (NYCBS), we create an environment where dedicated professionals can thrive. Our team of expert oncologists, hematologists, and compassionate staff work across numerous locations with one shared mission: conquering cancer close to home. Through cutting-edge treatments, innovative research, and a patient-centered philosophy, we are redefining what’s possible in the fight against cancer and blood disorders. Join our growing organization and help us bring healing, hope, and advanced care to the communities we proudly serve.
In this role, you will:
- Run and work daily Business Office Report in OncoEMR for drug order values: Required, Pending, Auth Issue (Onsite), P2P, and Denied for current date of service as well as 1-2 days out. All STAT orders are to be worked immediately upon request by onsite team
- Work all cases for Revlimid, Thalomid, and Pomalyst orders daily/monthly in obtaining new scripts, new authorizations, and notifying the pharmacy/patient of approvals as required
- Run and work daily Radiology Scheduling Report for order status: Pending, Auth Issue (Onsite), P2P, and Denied. All STAT orders are to be worked immediately upon request by onsite team
- Respond to daily query sheets from third party Fedora on Radiology orders
- Refer orders to Eligibility/Referral team for insurance checks or to Financial Counselor for patient assistance on drug orders
- Ensure that all aspects of approval have been checked including prior authorization, pre-determination, and pre-certification before approving the order as meeting NYCBS policy
- Ensure that all appropriate diagnoses are listed in the patient’s summary for drug order
- Document in OncoEMR the patient’s treatment plan and approval status. Must document all steps taken in research/process of the case
- Verify the patient's own drug with pharmacy related queries where applicable
- Notify Nursing Management if orders need to be changed on treatment plan to BB (patient’s own drug) or Buy/Bill (billing through medical insurance) or if a script is needed to script out to outside pharmacies for patient’s drugs
- Any patients that do not have a completed approval status by 4pm EST must be reviewed with the manager to determine if appointment should be rescheduled
- Respond to all messages left on the 121 (prior authorization group line) before end of business each day
- Work any prior authorization requests from local pharmacies on patient’s oral medications or on specialty pharmacy drugs
- Work closely with third party vendor Fedora to ensure authorizations are in place and insurance benefits are accurate
- Maintain and ensure the confidentiality of all patient and employee information at all times
- A drug & radiology specialist will be expected to work when given sufficient notice of required overtime
- High school or GED required
- Experience in pharmacy / authorization field
- Experience working in the healthcare field, preferably in a clinical setting or business office
- Experience in insurance requirements and medical terminology ICD-10 and CPT coding
- Experience in billing practice management systems, electronic medical record systems, Microsoft
- Word, and Microsoft Excel
- Excellent verbal and communication skills between co-workers, physicians, management staff,
- patients, insurances, outside programs
- Ability to multitask, problem solve, utilize basic math skills and follow complex instructions
- Must have the ability to converse in a calm and friendly manner
- Able to relate and comfort patients during a difficult time
Starting:$26/hr based on experience and education
Benefits: Health Insurance on day 1, Dental, Vision, Life Insurance, Short- and Long-term disability, 401k Plan, generous PTO, 8 paid holidays (2 floating)
Join us at NYCBS, where we are making strides in healthcare through innovative and compassionate care.
Visit our website at: Nycancer.com
Follow us on Facebook: NYCBS on Facebook
*New York Cancer and Blood Specialists is an Equal Opportunity Employer.*
Powered by JazzHR
2zejrsfsYI
Salary : $26
