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Oncology Patient Revenue Specialist

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Nuvance HealthPoughkeepsie, NY
Full-time
  • Nuvance Health has a network of convenient hospital and outpatient locations - Danbury Hospital, New Milford Hospital, Norwalk Hospital and Sharon Hospital in Connecticut, and Northern Dutchess Hospital, Putnam Hospital Center and Vassar Brothers Medical Center in New York - plus multiple primary and specialty care physician practices locations, including The Heart Center, a leading provider of cardiology care, and two urgent care offices.
  • Non-acute care is offered through various affiliates, including the Thompson House for rehabilitation and skilled nursing services, and the Home Care organizations.
  • Title: Prior Authorization Specialist - Radiation Oncology (Oncology Patient Revenue Specialist) Our Cancer program is made up of three centers located in New York - Putnam, Poughkeepsie and Kingston.
  • This position is Full time, Monday - Friday 8:00am - 4:30pm (flex).
  • No weekends or holidays are required.
  • Purpose: Nuvance Health Radiation Oncology is looking for an enthusiastic and self-motivated prior authorization specialist to join the team.
  • This role oversees system radiation oncology authorizations for treatment and ordered diagnostic tests in a timely and effective manner to ensure efficient operations and delivery of patient care.
  • The ideal candidate is patient focused, an effective communicator, self-starter, and has a keen attention to detail.
  • Responsibilities:itiates prior authorizations for medical procedures, tests, and prescriptions as requested by staff, providers, and/or insurers.
  • Documents all prior authorization activities and record activity in the practice management system.
  • Prioritizes and organizes all prior authorization activities.
  • Serve as liaison between patient and insurer & patient and practice.
  • Reviews the appointment schedule up to three (3) days in advance to ensure proper obtaining of authorizations, pre-certifications and referrals prior to services being rendered for patients as required by the different insurance plans/carriers.
  • Identifies self-pay patients.
  • Maintain and Model REACH Values (Respect, Excellence, Accountability, Compassion, Honor).
  • Demonstrates regular, reliable, and predictable attendance.
  • Performs other duties as required.
  • Education and Experience Requirements: Bachelor's degree or equivalent experience Minimum three (3) years relevant experience in Ambulatory, clinic setting, or insurance company with revenue cycle experience.
  • Knowledge of CPT and ICD-10 coding practices and medical terminology Experience working with oncology strongly preferredMinimum Knowledge, Skills and Abilities Requirements: Detailed oriented.
  • Proficient in Microsoft Office, Excel and Access.
  • Knowledge of healthcare reimbursement and third-party payer guidelines.
  • Strong analytic aptitude.
  • Excellent project management skills.
  • We will endeavor to make a reasonable accommodation to the known physical or mental limitations of a qualified applicant with a disability unless the accommodation would impose an undue hardship on the operation of our business.
  • If you believe you require such assistance to complete this form or to participate in an interview, please contact Human Resources at 203-739-7330 (for reasonable accommodation requests only).
  • Please provide all information requested to assure that you are considered for current or future opportunities.

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