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- Tasks: Coordinate insurance authorisations and communicate with providers about medication approvals.
- Company: Join a supportive healthcare team dedicated to patient care.
- Benefits: Competitive pay, health benefits, and opportunities for professional growth.
- Why this job: Make a difference in patients' lives by ensuring they receive necessary treatments.
- Qualifications: High School Diploma or GED; typing skills required.
- Other info: Work in a dynamic office environment with a focus on teamwork.
The predicted salary is between 30000 - 45000 £ per year.
JOB SUMMARY
Responsible for coordinating the insurance authorization and pre-certification of scheduled medications and labs and communicating the denials as necessary.
DUTIES AND ESSENTIAL FUNCTIONS
Overall performance rating of below indicated essential job duties:
- Responsible for tracking, obtaining & extending authorizations in a timely manner.
- Records insurance information utilizing standardized documentation practices through the entire pre-cert/authorization process.
- Obtains, interprets & submits clinical documentation pertinent to the specific services requiring prior authorization to support reviews by the payer.
- Obtains & documents prior authorization approval from the insurance companies for services and communicates professionally and timely to the provider/clinical staff regarding authorization status or delays.
- Follows up on denied authorization requests.
- Facilitates peer-to-peer conversations between the insurance carrier and the ordering provider when required to obtain authorizations for services.
- Provides support to other departments to clarify claim denial appeal efforts.
- May work to resolve claims denials related to the prior authorization process.
EDUCATION/LICENSE/CERTIFICATION/OTHER REQUIREMENTS
Minimum requirement: High School Diploma or GED
Must type 35 words per minute
Preferred qualifications: Knowledge of medications associated with infusion center
WORKING ENVIRONMENT
Works indoors in an office/clinic setting. The noise level is usually moderate.
PHYSICAL DEMANDS
Constantly required to maintain a stationary position behind a computer.
Frequently required to move about inside the department.
Constantly required to communicate telephonically and face to face with colleagues and customers.
Constantly required to operate a computer and telephone.
Constantly required to lift and/or move up to 10 pounds.
Frequently required to lift and/or move up to 25 pounds.
Occasionally required to lift and/or move up to 50 pounds.
Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, and depth perception.
Reimbursement Specialist-Onc M in Portsmouth employer: King's Daughters Medical Center
Contact Detail:
King's Daughters Medical Center Recruiting Team
StudySmarter Expert Advice 🤫
We think this is how you could land Reimbursement Specialist-Onc M in Portsmouth
✨Tip Number 1
Network like a pro! Reach out to people in the industry, attend relevant events, and connect on LinkedIn. You never know who might have the inside scoop on job openings or can put in a good word for you.
✨Tip Number 2
Practice your pitch! Be ready to explain why you're the perfect fit for the Reimbursement Specialist role. Highlight your skills in tracking authorisations and handling denials – make it sound effortless!
✨Tip Number 3
Follow up after interviews! A quick thank-you email can go a long way. Remind them of your enthusiasm for the role and reiterate how your experience aligns with their needs.
✨Tip Number 4
Apply through our website! It’s the best way to ensure your application gets seen. Plus, we love seeing candidates who take that extra step to engage with us directly.
We think you need these skills to ace Reimbursement Specialist-Onc M in Portsmouth
Some tips for your application 🫡
Tailor Your Application: Make sure to customise your CV and cover letter for the Reimbursement Specialist role. Highlight your experience with insurance authorisations and any relevant skills that match the job description. We want to see how you fit into our team!
Showcase Your Communication Skills: Since this role involves a lot of communication, emphasise your ability to convey information clearly and professionally. Mention any experiences where you've successfully communicated with providers or insurance companies, as this will resonate with us.
Be Detail-Oriented: Attention to detail is key in this position. In your application, provide examples of how you've tracked and documented information accurately in previous roles. We love candidates who can demonstrate their meticulous nature!
Apply Through Our Website: We encourage you to submit your application through our website. It’s the best way for us to receive your details directly and ensures you’re considered for the role. Plus, it’s super easy!
How to prepare for a job interview at King's Daughters Medical Center
✨Know Your Stuff
Make sure you brush up on the specifics of insurance authorisation and pre-certification processes. Familiarise yourself with common medications used in infusion centres, as this will show your potential employer that you're serious about the role.
✨Practice Makes Perfect
Rehearse answers to common interview questions related to handling denials and communicating with providers. You could even role-play with a friend to get comfortable discussing how you would facilitate peer-to-peer conversations.
✨Be Ready to Share Examples
Prepare specific examples from your past experiences where you've successfully tracked authorisations or resolved claim denials. This will help demonstrate your problem-solving skills and ability to work under pressure.
✨Ask Smart Questions
At the end of the interview, have a few thoughtful questions ready about the company’s processes or team dynamics. This shows your interest in the role and helps you gauge if it’s the right fit for you.