About this role
Clearview Cancer Institute is north Alabama's leading cancer treatment facility. For over 30 years Clearview Cancer Institute has provided leading-edge treatment and compassionate care to those diagnosed with cancer or blood disorders. Clearview offers every service and amenity needed in an outpatient setting and our dedication to research and involvement in Phase I-IV clinical trials gives our patients the opportunity to receive potentially life-saving treatment options.
Why Join Us? We are looking for talented and highly-motivated individuals who demonstrate a natural desire to support the meaningful work of community oncologists and the patients we serve.
Job Description:
Job Purpose
The purpose of the Insurance Benefits Representative is to verify eligibility, benefits, managed care, and maintain referrals on a monthly basis.
Essential Job Functions
- Monthly verification of all insurance including managed care policies. Notify other departments of uninsured or under-insured patients.
- Resolve managed care issues such as authorization for services, billing, and claims payments.
- Understand and explain insurance benefits and issues as well as managed care coverage with patients.
- Other duties as assigned.
Qualifications
- Must be able to work in a fast-paced, multi-tasking environment.
- Must be familiar with HIPAA and confidentiality laws.
- Must be able to prioritize and manage time efficiently.
- Must be able to communicate effectively both verbally and in written communications.
- Must be team-oriented.
- Must have knowledge of Excel, insurance benefits, coordination of benefits, and managed care referrals.
- Must have capability of verifying eligibility, benefits, and be familiar with various insurance company policies, terms, and conditions.
Education/Experience
- Must have a high school diploma or equivalent.
- Must have at least (2) years experience in medical billing.
Working Conditions
This position works in clinical business office setting. This position requires the employee be able to use basic office equipment and multiple software systems in a team-oriented environment. This position has direct contact with patients.
Physical Requirements
This position requires the employee sit at a desk for much of the day, up to two-thirds of the day. This position also requires the employee be in front of a computer for at least two-thirds of the day.
Direct reports
This position is not a supervisory position.
Other facts
About OneOncology
Tennessee Oncology is one of the nation’s largest community-based cancer care specialists and home to one of the leading clinical trial networks in the country.
Established 1976 in Nashville, Tennessee Oncology’s mission remains unchanged: To provide access to high quality cancer care and the expertise of clinical research for all patients at convenient locations within their community and close to their home. To this day, our growing network of physicians and number of locations is based on this mission. In 2018, Tennessee Oncology joined OneOncology, a partnership of oncologists and industry leading experts driving the future of community-based cancer care in the United States, as a founding practice partner.
Physicians specializing in gynecologic oncology, palliative care, radiation oncology, and health psychology comprise our group.
Tennessee Oncology provides a full range of diagnostic services, including oncology specific expertise in PET/CT and laboratory services. Clinic locations provide on-site chemotherapy treatments so that patients receive care in their community and close to their home.
Our physicians utilize the latest in molecular diagnostics and profiling to choose treatments specific to the genetics of your cancer.
Oncology research is the largest area of new drug development. Self -administered medications, those taken by mouth or injected by the patient, comprise approximately 40% of these investigative medications. Tennessee Oncology’s in house pharmacy, Park Pharmacy, stocks oncology and hematology medications not readily available at community retail pharmacies. A URAC accredited Specialty Pharmacy, Park provides insurance and benefits investigation, prior authorization services for insurance coverage, co-pay assistance through manufacturer or foundation programs, extensive medication education, and access to a pharmacist 24 hours a day, 7 days a week.
What you'll do
- The Insurance Benefits Representative is responsible for verifying eligibility, benefits, managed care, and maintaining referrals on a monthly basis. This includes resolving managed care issues and explaining insurance benefits to patients.
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