Job Abstract

This Full-time Opportunity will work 80 hours bi-weekly.

Monday - Friday

Shifts: 7:30a - 4p, 8a - 4:30p, 8:30a - 5p

Benefit Package that includes Medical/Dental/Vision insurance, Life Insurance, Short and Long Term Disability,

403B Retirement Savings Program and Paid Time Off

Position Summary:

The Oncology and Hematology Authorization Specialist is responsible for monitoring, obtaining, pre-authorizing, generating appeals, coordinate peer to peer review for IV infusion and oral medications as well as radiology exams and genetic testing.

Supports the Mission of Frederick Health and complies with the health system’s Standards of Behavior.

Skills and Abilities:

Must be able to define meaningful cause and effect situations related to professional fee claims rejections and denials;
• Demonstrated competency with medical procedural coding (CPT/ICD10);
• Must demonstrate excellent interpersonal skills, customer orientation, and the ability to interact with personnel of all levels within the organization and work within a multi-disciplinary team environment;
• Excellent oral and written communication;
• Professional manner and attire;
• Ability to clearly articulate administrative processes for policy implementation;
• Must be an intermediate to extensive PC user, and be able to maintain (create, edit, professional output) Microsoft Office products efficiently (Word, Excel, Power Point)."

Minimum Qualifications:

• Physician billing experience with demonstrated working knowledge of professional fee billing transactions and regulations, claims, insurance carriers, rejection and denial codes, error correction and re-posting and contractual adjustments;
• Completion of a high school diploma. College level courses preferred but not required;
• Prior experience and demonstrated competence with patient or customer information systems
• Must be able to define meaningful cause and effect situations related to professional fee claims rejections and denials;
• Demonstrated competency with medical procedural coding (CPT/ICD10);

Must demonstrate and maintain current knowledge and skills in providing appropriate care/contact for patients in the following age groups:

__ Neonate (0 thru 30 days)
__ Infant (31 thru 12 months)
__ Child (13 months thru 12 years)
__ Adolescent (13 years thru 17 years)
__ Adult (18 years thru 65 years)
__ Geriatric (66+ years)

Must demonstrate knowledge of the principles of growth and development over the life span and possess the ability to assess data reflective of the patient’s status. Possess the ability to interpret the appropriate information needed to identify each patient’s requirements relative to his/her age-specific needs and to provide the care needed as described in the unit’s/department’s policies and procedures – Not applicable.

Physical Demands:

Sedentary – Light Work – Lifting up to 15 pounds on an infrequent basis (less than one lift every three minutes). While work is mostly done sitting, a certain amount of walking or standing is often necessary.

Ergonomic Risk Factors:

Repetition: Repeating the same motion over and over again places stress on the muscles and tendons. The severity of risk depends on how often the action is repeated, the speed of the movement, the required force and muscle involved

Awkward Posture: Posture is the position your body is in and its effect on the muscle groups that are involved in the physical activity. Awkward postures include repeated or prolonged reaching, bending, kneeling, squatting, working overhead with you hands or arms, or holding fixed

Working Conditions:
Blood borne Pathogen Exposure Risk Category C – NO exposure to blood or body fluids.

Reporting Relationship:
The Authorization Specialist reports to the office supervisor.