About this role
Employment Type: Full Time
REMOTE
Benefits: M/D/V, Life Ins., 401(k)
Pay Range: $62,000-$78,000 annually based on experience
SCOPE: Supervises day-to-day revenue cycle operations to maximize the collection of payments and reimbursements from patients, insurance carriers, financial assistance programs, and guarantors. Supports and adheres to the Compliance Program, including the Code of Ethics and Business Standards.
The US Oncology Network is a thriving organization that fosters forward-thinking, advancement opportunities, and an inspired work environment. We continuously look for top talent who will continue to propel our organization in the right direction and celebrate new successes! Come join our team in the fight against cancer!
About US Oncology
The US Oncology Network is one of the nation’s largest networks of community-based oncology physicians dedicated to advancing cancer care in America. The US Oncology Network is supported by McKesson Corporation focused on empowering a vibrant and sustainable community patient care delivery system to advance the science, technology, and quality of care. For more information, visit www.usoncology.com. We extend an extremely competitive offering of benefits to employees, including Medical Health Care, Dental Care, Vision Plan, 401-K with a matching component, Life Insurance, Short-term and Long-term disability, and Wellness & Perks Programs.
Responsibilities
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Collects patient documentation and charts for claim submission. Ensures claim forms are completely and Supervises the daily operations of the Prior Authorization team, ensuring timely and accurate submission, follow-up, and resolution of authorization requests. Oversees work queue management, productivity, quality, denial management, appeals support, and compliance with organizational and payer requirements.
- Serves as the escalation point for complex authorization issues, collaborating with providers, practices, payers, and leadership to resolve barriers and minimize delays in patient care.
- Ensures adherence to standard operating procedures (SOPs), payer guidelines, regulatory requirements, and departmental turnaround time expectations through regular auditing and quality reviews.
- Monitors and analyzes key performance indicators, including authorization turnaround times, work queue aging, approval rates, denial trends, productivity, quality, and treatment delays. Identifies opportunities for process improvement and operational efficiency.
- Identifies trends related to authorization denials, payer policy changes, and workflow challenges, and partners with leadership to develop and implement corrective actions.
- Champions process improvements, system enhancements, and operational initiatives that improve team performance, patient access, and the overall provider experience.
- Develops, implements, and supports training programs for authorization staff, including onboarding, workflow education, payer requirements, systems training, and ongoing professional development.
- Guides team members toward departmental goals and priorities through coaching, performance management, accountability, and continuous feedback.
- Responsible for interviewing, hiring recommendations, performance evaluations, employee development, disciplinary actions, and enforcement of company policies and standards.
- Performs other duties as assigned.
Qualifications
MINIMUM QUALIFICATIONS
- Associate degree in Finance, Business, or equivalent OR four years of revenue cycle experience required.
- At least four (4) years of medical revenue cycle work experience with a consistent track record of achieving metrics.
- Two years of experience managing, delegating, and following up on work priorities strongly desired.
- Strong knowledge of medical insurance billing and collections with CPT, ICD-10, and HCPCS coding and medical terminology, as well as an understanding of managed care products (HMO, PPO, etc.).
- Proficiency in Microsoft Office (Outlook, Excel, Word, and PowerPoint).
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is primarily required to remain in a stationary position for extended periods of time, operate a computer and other standard office equipment, communicate effectively via telephone and virtual platforms, and occasionally move within the home workspace. Vision, hearing, and manual dexterity sufficient to perform keyboarding and screen-based work are required.
WORK ENVIRONMENT
This is a fully remote position. The work environment is a home-based office setting. Work is performed primarily using a computer, telephone, and other remote collaboration tools. The role involves frequent virtual interaction with coworkers, leaders, and internal or external stakeholders.
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