Physician Practice Representative- Pediatric Hematology/Oncology

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You&rsquo;ll play a key role in managing insurance verification, scheduling new and follow-up appointments.</p><ul type=\"disc\"><li style=\"font-family: arial, sans-serif;\">Inputs new patient information and updates information in our EMR system</li><li style=\"font-family: arial, sans-serif;\">Analyzes patient records and insurance policies to determine if procedures, treatments, or medications require prior authorization</li><li style=\"font-family: arial, sans-serif;\">Ensure patients are eligible for services and that insurance benefits are accurate&nbsp;</li><li style=\"font-family: arial, sans-serif;\">Notifies providers of potential coverage options</li><li style=\"font-family: arial, sans-serif;\">Communicates with patients about the authorization process and any potential delays or financial implications.&nbsp;</li><li style=\"font-family: arial, sans-serif;\">Interacts with healthcare providers, insurance companies, and patients to obtain and provide information needed for authorization decisions</li><li style=\"font-family: arial, sans-serif;\">Compiles and submits detailed authorization requests to insurance companies, including all necessary documentation</li><li style=\"font-family: arial, sans-serif;\">Completes/obtains authorizations and referrals for services, including appointments, procedures, infusions, and medications</li><li style=\"font-family: arial, sans-serif;\">Researches and resolves any issues or discrepancies related to authorization requests</li><li style=\"font-family: arial, sans-serif;\">Monitors and follows up on authorization requests to ensure timely processing</li><li style=\"font-family: arial, sans-serif;\">Investigates insurance denials and resubmit requests or appeals when necessary. &nbsp;</li><li style=\"font-family: arial, sans-serif;\">Monitors schedule for potential issues</li><li style=\"font-family: arial, sans-serif;\">Remains informed about healthcare industry regulations, trends and insurance policies</li><li style=\"font-family: arial, sans-serif;\">Performs other related duties as assigned by management. &nbsp;</li></ul><p><span style=\"font-family: arial,sans-serif;\"><br><strong>QUALIFICATIONS: &nbsp;</strong></span></p><ul><li style=\"font-family: arial, sans-serif;\">High school diploma or general education degree (GED), or 2+ years related experience and/or training, or equivalent combination of education and experience.</li><li style=\"font-family: arial, sans-serif;\">Computer skills required: Microsoft Outlook, Word, Excel and Adobe; Experience working with medical practice management software a plus.</li><li style=\"font-family: arial, sans-serif;\">Other skills required:&nbsp;<ol start=\"1\" type=\"1\" id=\"isPasted\" style=\"font-family: initial;\"><li style=\"font-family: arial, sans-serif;\">Experience working in a physician practice.</li><li style=\"font-family: arial, sans-serif;\">Knowledge of medical terms and medical insurance&nbsp;</li><li style=\"font-family: arial, sans-serif;\">Experience in requesting/submitting prior authorization for various diagnostic exams, prescriptions, etc.&nbsp;</li><li style=\"font-family: arial, sans-serif;\">Professional demeanor and appearance.</li><li style=\"font-family: arial, sans-serif;\">Strong interpersonal and communication skills.</li><li style=\"font-family: arial, sans-serif;\">Meticulous attention to detail.</li><li style=\"font-family: arial, sans-serif;\">Proficient in Microsoft Office Suite (Word, Excel, Outlook)</li></ol></li></ul><p><span style=\"font-family: arial,sans-serif;\"><strong>&nbsp;</strong></span></p><p style='margin:0in;font-size:16px;font-family:\"Aptos\",sans-serif;background:white;' data-pasted=\"true\"><strong><span style=\"color:black;\">JOB TYPE / WORK SCHEDULE:&nbsp;</span></strong></p><ul style=\"margin-bottom:0in;margin-top:0in;\" type=\"disc\"><li style=\"margin:0in;font-size:16px;font-family: initial;background:white;\"><span style='font-family:\"Times New Roman\";color:black;'>This is a full-time position, in-office position</span></li><li style=\"margin:0in;font-size:16px;font-family: initial;\"><span style='font-family:\"Times New Roman\";'>Standard office hours are Monday through Friday, 8:00 a.m. &ndash; 4:30 p.m.&nbsp;</span></li><li style=\"margin:0in;font-size:16px;font-family: initial;\"><span style='font-family:\"Times New Roman\";'>Bilingual Preferred</span></li></ul><p><br></p><p style='margin:0in;font-size:16px;font-family:\"Aptos\",sans-serif;' data-pasted=\"true\">Competitive pay and full benefits package, including 401(k), health, dental, vision, life, and disability insurance.</p></div></div></div></div></div></div></div></div></div></div></div></div>\n",
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