BJC HealthCare
Oncology and Infusion Reimbursement Specialist
Saint Luke's Hospital | 4401 Wornall Rd | Kansas City | MO · Full-time
Sponsorship not specifiedDetected 1 day ago
ComplianceExcelPremiere ProHIPAAEpicICD-10PharmacologyPatient CareLeadershipCommunicationMicrosoft Office
About the role
- Treatments include chemotherapy, surgery, radiation therapy, office visits, hospital stays, counseling, nutrition, and other cancer-related therapies.
- This position has the capacity to hybrid in the Kansas City area.
Responsibilities
- Maintains a focus on accuracy, timeliness, and adherence to processes to facilitate patient access to treatments.
- Documents case activity, communications, and correspondence in Epic to ensure completeness and accuracy of account activity, and that actions are taken to resolve outstanding authorization issues.
- Performs or coordinates insurance verification with third-party payers.
Requirements
- Familiarity with basic functions of an EMR.
- Associate's degree in health sciences and/or medical records certification, preferred.
- Minimum five years medical business office experience with referrals, third party benefit verifications, treatment authorizations and patient interaction, required.
- Working knowledge of healthcare insurance, particularly Medicare and Medicaid.
- Knowledge of diagnostic (ICD-10), procedural (CPT, HCPCS) coding and cancer terminology, required. Knowledge of NCCN guidelines for drug therapy indications and patient advocacy and drug replacement programs, a plus.
- Basic Microsoft Office computer skills, including Excel, Word, and Outlook.
- Infusion and chemotherapy knowledge is a must.
- Job Requirements
- Applicable Experience:
- Job Details
- Full Time
Nice to have
- Knowledge of diagnostic (ICD-10), procedural (CPT, HCPCS) coding and cancer terminology, required.
- Knowledge of NCCN guidelines for drug therapy indications and patient advocacy and drug replacement programs, a plus.
Benefits
- Saint Luke's 12,000 employees strive toward that vision every day.
- Our employees are proud to work for the only faith-based, nonprofit, locally owned health system in Kansas City.
- Coordinates with Oncology and Infusion Reimbursement Specialist regarding treatment authorizations.
- Serves as a point of contact with patients and strives to keep them continuously informed of coverage and authorization issues.
- Re-verifies benefits and ensures authorization and/or referral after treatment plan has been discussed prior to the initiation of treatment.
- Communicates to the treatment team any anticipated issues with coverage that may impact the sequencing and timeliness of care.
- Tracks, reports, and escalates to leadership service issues arising from insurance coverage or other issues that delay service, to ensure patient access and to avoid delays that may interrupt therapy and treatment plans.
- May assist with the resolution of problem claim reimbursement issues on occasion.
Equal opportunity
- Equal Opportunity Employer.
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This listing is sourced directly from BJC HealthCare's careers page and normalized into a canonical job model.