Job Details

Primary responsibility is to obtain prior authorization from insurance companies for patients receiving chemotherapy. This includes electronically access insurance company website portals and/or contact via telephone or fax to request prior authorization. Ensuring appropriate ICDl0 codes are associated with the patients EMR prior to these prior authorization requests. Communicating with treatment team (nurses/doctors/manager) on prior authorization status. Appropriate documentation of denied/approval authorizations. Verifies patient demographic and insurance information in RCX and Cemer billing systems. Batches all IC10 and CPT's for outpatient billing documentation. Enters charge batches into RCX rules and Cemer billing systems in a timely fashion. Reconciles batch totals, logs and files completed batches. Denial management for all authorization rejected claims.

Job Description

High School Diploma required. At least one year billing experience required with knowledge of CPT and ICDI0 coding, patient registration and third party insurances. Experience with RCX rules, Cemer Registration, iPAS, Cerner and RCX charge entry and payment posting functions preferred. Knowledge of Artiva Denial Management preferred. Knowledge of Chemotherapy drugs preferred.

Work Shift

Workday Day (United States of America)

Worker Sub Type

Regular

Employee Entity

Albert Einstein Medical Center

Primary Location Address

5501 Old York Road, Philadelphia, Pennsylvania, United States of America

Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students. Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.    

Jefferson is committed to providing equal educa­tional and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status. 

Benefits

Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.

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