Radiation/Oncology Verification Specialist

Description

Responsible for verifying insurance benefits, obtaining precertification or predetermination if required along with making sure a valid referral is on file if needed for both radiation & medical oncology as well as provide financial counseling to patients prior to their scheduled appointments.

• Contacts the insurance company for eligibility & benefits, obtaining precertification or predetermination if required along with making sure a valid referral is on file if needed.
  Answer incoming department calls and assist patients with their benefit inquiries & quotes.
• Communicates with Physician’s MA to obtain clinical information as needed for precertification and/or predeterminations.
• Documents benefits in insurance maintenance screen of medical billing system.
• Contacts Patient to notify them of their portion for upcoming appointment. 
• Documents any communication made to patient in chart notes of medical billing system.
• Documents amount to collect for upcoming visit within the patient’s appointment outside of any copayments.
• Reviews the ledger for any outstanding balances and notifies collector via Nextgen PM email.
• Maintain department target date of 10 days out. 
• Assist department with schedules in the event of an absence or staff shortage.
• Rotating Kitchen & Fax Duty

Qualifications

Education and/or Experience:   

• High school diploma or equivalent.
• Effective communication skills, including verbal, written and telephone. 
• Proficient in mathematical skills
• Able to multitask, be motivated and team player with positive attitude 
• Experience with insurance verification of benefits as well as precertification, predeterminations, and referrals. 
• Medical and Radiation oncology experience necessary.
• Advanced Radiology experience a plus 
• Urology and medical terminology knowledge