Contract
Aston Carter
Austin, TX, USA
Description:* Reviews chemotherapy regimens in accordance to reimbursement guidelines. Obtains necessary pre-certifications and exceptions to ensure no delay in reimbursement of treatments. Researches denied services and alternative resources to pay for treatment. ***obtaining authorizations from insurance companies is a must*** -Reviews, processes and audits the medical necessity for each patient chemotherapy treatment and documentation of regimen relative to pathway adherence. -Communicates with nursing and medical staff to inform them of any restrictions or special requirements in accordance with particular insurance plans. Updates coding/payer guidelines for clinical staff. Tracks pathways and performs various other business office functions on an as needed basis - Obtains insurance authorization and pre-certification specifically for chemotherapy services. Works as a patient advocate and functions as a liaison between the patient and payer to answer reimbursement...