The Oncology Eligibility Coordinator will assist in all aspects of determining eligibility and enrolling patients. They will review and understand requirements that determine eligibility, navigate through medical records, understand Oncology terminology and use critical thinking to gather data to summarize the treatment plan for each patient. Additional job functions include: Providing completed work each day to the payer, answering questions about enrolled patients and marking outcomes of eligibility into the system. They will also communicate with the billing department and maintain reports / spreadsheets.
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*Position is Remote: Houston, Conroe, The Woodlands area. Will be required to come to The Woodlands office for training.
Responsibilities:
1. Determine patient eligibility for Innovent programs:
Follows specific contract requirements???must understand details of contracts
Navigate through multiple IT systems
Review of Electronic Medical Records for active treatments and plan of care
Understanding of Oncology Chemotherapy treatments ( IV/Oral /Hormonal)
Verification of insurance benefits
Responsible for understanding basic billing rules for episodes
Understanding of different Payment Conditions
2. Communication with Provider and Payers
Answer questions from Payer about eligibility and Payment conditions
Discuss with Provider basic rules for billing of episodes
Work with Analytics team regarding gathered data
3. Assist in all aspects of enrolling eligible patients into Innovent Programs:
Document in Innovent IT systems
Populate all required information into the Payer Spreadsheets
Outreach to provider to obtain missing clinical data
Populate all data on Master Spreadsheet
4. Assist with reviewing patients as needed for payer and provider audits of enrolled patients.
Working hours: Various Shifts Available
Skills:
Oncology terminology
Understanding of Adjuvant and Metastatic patients
Understanding of IV Chemotherapy treatments /Hormonal only treatments / Palliative Care
Understanding of reading a Pathology /CT /PET etc reports and determining the outcome
Education:
High School
Experience:
1-4 years
Qualifications:
Knowledge of Medical Terminology
Advanced Microsoft Word, Outlook
Analytical Thinker and Problem Solver ???Extremely important
Self Motivator ??? works efficiently without daily direction
Highly Organized
Multitasker who can prioritize job duties
Excellent Telephone Skills
Apply Now!
Spherion has helped thousands of people just like you find work happiness! Our experienced staff will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. No one works harder for you than Spherion. EEO Employer: Race, Religion, Color, National Origin, Citizenship, Sex, Sexual Orientation, Gender Identity, Age, Disability, Ancestry, Veteran Status, Genetic Information, Service in the Uniformed Services or any other classification protected by law.
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The Oncology Eligibility Coordinator will assist in all aspects of determining eligibility and enrolling patients. They will review and understand requirements that determine eligibility, navigate through medical records, understand Oncology terminology and use critical thinking to gather data to summarize the treatment plan for each patient. Additional job functions include: Providing completed work each day to the payer, answering questions about enrolled patients and marking outcomes of eligibility into the system. They will also communicate with the billing department and maintain reports / spreadsheets.
*Position is Remote: Houston, Conroe, The Woodlands area. Will be required to come to The Woodlands office for training.
Responsibilities:
1. Determine patient eligibility for Innovent programs:
Follows specific contract requirements???must understand details of contracts
Navigate through multiple IT systems
Review of Electronic Medical Records for active treatments and plan of care
Understanding of Oncology Chemotherapy treatments ( IV/Oral /Hormonal)
Verification of insurance benefits
Responsible for understanding basic billing rules for episodes
...
Understanding of different Payment Conditions
2. Communication with Provider and Payers
Answer questions from Payer about eligibility and Payment conditions
Discuss with Provider basic rules for billing of episodes
Work with Analytics team regarding gathered data
3. Assist in all aspects of enrolling eligible patients into Innovent Programs:
Document in Innovent IT systems
Populate all required information into the Payer Spreadsheets
Outreach to provider to obtain missing clinical data
Populate all data on Master Spreadsheet
4. Assist with reviewing patients as needed for payer and provider audits of enrolled patients.
Working hours: Various Shifts Available
Skills:
Oncology terminology
Understanding of Adjuvant and Metastatic patients
Understanding of IV Chemotherapy treatments /Hormonal only treatments / Palliative Care
Understanding of reading a Pathology /CT /PET etc reports and determining the outcome
Education:
High School
Experience:
1-4 years
Qualifications:
Knowledge of Medical Terminology
Advanced Microsoft Word, Outlook
Analytical Thinker and Problem Solver ???Extremely important
Self Motivator ??? works efficiently without daily direction
Highly Organized
Multitasker who can prioritize job duties
Excellent Telephone Skills
Apply Now!
Spherion has helped thousands of people just like you find work happiness! Our experienced staff will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. No one works harder for you than Spherion. EEO Employer: Race, Religion, Color, National Origin, Citizenship, Sex, Sexual Orientation, Gender Identity, Age, Disability, Ancestry, Veteran Status, Genetic Information, Service in the Uniformed Services or any other classification protected by law.
Show lessShow more