Job: Insurance Verification Specialist

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Job Description

Ironwood Cancer & Research Centers has beautiful state-of-the-art integrated Cancer and Breast Centers, with locations strategically located throughout the Valley. Each one provides a superior cancer care environment with a full spectrum of cancer related services for patients. Our multi-disciplinary team approach includes surgical oncology, medical oncology, radiation oncology, diagnostic imaging services, social service support, nutritionist, integrative services, and genetic counseling.

Mission Statement:  To serve the community by providing quality, comprehensive cancer care which respects the values and needs of each individual.

Overview:  We are currently looking for a qualified and experienced Insurance Verification Specialist to work at our Central Business Office in the East Valley.  Verifies patient’s insurance coverage for every patient on the schedule for office visits or treatment. Obtain full insurance benefits for every patient that gets medical or radiation treatment in our office every 6 months minimum.

Schedule:  This is a full-time, day-shift position working a Monday - Friday schedule.

Essential Duties and Responsibilities:

  • Verify eligibility and benefits plus load insurance for all new patients.
  • Verify eligibility and benefits plus load insurance for patients with a change of insurance.
  • Re-verify eligibility and benefits on existing patients prior to first visit of a new year.
  • Work schedules and add-ons to identify patients that need re-verifications.
  • Create schedules and add-ons to schedules in Excel. 
  • Work QCL’s before their due date; STAT QCL’s are to be worked immediately.
  • Notify Benefit Coordinators on all insurance changes; also notify Test Schedulers, Drug Authorization and/or Accounts Receivable if the change affects them as well.
  • Create and send schedule batches to ZirMed on a daily basis maintaining 3 days out.
  • Work all responses with errors; check all Medicare to see if patient is on a Medicare replacement; check all AHCCCS to verify plan hasn’t changed; check all AARP Medicare Complete HMO and HealthNet HMO to verify network hasn’t changed.
  • Obtain referrals maintaining 2 weeks out on schedule.
  • Complete all daily, weekly and monthly checklists. Weekly reports to management.
  • Any other duties requested by management.

Knowledge and Skills:

  • Knowledge of oncology codes, drugs and radiation treatment codes necessary.
  • Extensive knowledge of insurance plans in Arizona and benefits as they relate to Medical Oncology and Radiation Oncology treatments.
  • Knowledge of Medical Office operations.
  • Knowledge of medical terminology.
  • Knowledge of chemotherapy related drugs, supplies utilized and SNF, LTC and Hospice in relation to insurance benefits.
  • Knowledge of CPT, ICD-9, HCPCS coding.

Education and Qualifications:

  • Minimum of 3 years in the healthcare reimbursement field.
  • Medical and Radiation Oncology experience preferred.
  • High school diploma or equivalent required.

We offer a competitive salary and a comprehensive benefit package including health insurance, 401K and a caring work environment. We are an E.O.E.

Visit our website at "Outsmarting Cancer One Patient at a Time"