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About the Role
Join a growing organization committed to healing, hope, and advanced care, and help make a meaningful impact in the fight against cancer and blood disorders.
Responsibilities
- Run and work daily Business Office Report in OncoEMR for drug order values.
- Verify and work NYCBS Pharm Fill for current date of service and one week out to obtain prior authorizations.
- Work all STAT orders immediately upon request by the onsite team.
- Work daily requests from onsite pharmacy dispensaries to obtain prior authorization on requested medication.
- Document notes in the Sig Box of OncoEMR, including approval status or in text note where applicable.
- Document all steps taken in research/process of the case.
- Prepare appeals for denials on prior authorization requests.
- Refer prescription fill requests that are denied or have patient financial responsibility to the pharmacy financial counselor.
- Ensure all aspects of approval (prior authorization, pre-determination, pre-certification) are checked before approving the order.
- Verify patient’s own drug with pharmacy related queries.
- Notify Nursing Management if orders need to be changed to BB (patient’s own drug) or to Buy/Bill.
- Work prior authorization requests from local pharmacies on patient’s oral medications or specialty pharmacy drugs.
- Maintain and ensure the confidentiality of all patient and employee information.
- Work required overtime with sufficient notice.
Requirements
- High school or GED required.
- Experience in pharmacy / authorization field.
- Experience working in the healthcare field, preferably in a clinical setting or business office.
- Experience in insurance requirements and medical terminology ICD-10 and CPT coding.
- Experience in billing practice management systems, electronic medical record systems, Microsoft Word, and Microsoft Excel.
- Excellent verbal and communication skills with co-workers, physicians, management staff, patients, insurances, and outside programs.
- Ability to multitask, problem solve, utilize basic math skills, and follow complex instructions.
- Ability to converse in a calm and friendly manner.
- Able to relate and comfort patients during a difficult time.
Education Level
- High school or GED
About the Company
- At New York Cancer & Blood Specialists (NYCBS), we are dedicated to making a difference in the lives of our patients, their families, and our communities.
- Our passionate team of expert oncologists, hematologists, and healthcare professionals work together to provide world-class cancer care close to home.
- By offering cutting-edge treatments, innovative research, and a patient-centered approach, we are redefining what’s possible in the fight against cancer and blood disorders.