Job Description

Rep, Authorizations - Tulsa, OK

Cancer care is all we do

Hope in healing

Cancer Treatment Centers of America® (CTCA®) takes a unique and integrative approach to cancer care. Our patient-centered care model is founded on a commitment to personalized medicine, tailoring a combination of treatments to the needs of each individual patient. At the same time, we support patients’ quality of life by offering therapies designed to help them manage the side effects of treatment, addressing their physical, spiritual and emotional needs, so they are better able to stay on their treatment regimens and get back to life. At the core of our whole-person approach is what we call the Mother Standard® of care, so named because it requires that we treat our patients, and one another, like we would want our loved ones to be treated. This innovative approach has earned our hospitals a Best Place to Work distinction and numerous accreditations. Each of us has a stake in the successful outcomes of every patient we treat.

Job Description:

Hours: Mon - Fri 9am - 5:30pm

Location: Tulsa, OK area

This position is responsible for the authorizations for medical services at Cancer Treatment Centers of America. This role will obtain accurate and timely decisions from payers regarding authorizations of medical procedures, high tech imaging services, surgical cases, personalized genomic medicine, technically advanced radiation therapy treatments, chemotherapy and any other procedure requiring authorization.  This position requires excellent time management and organizational skills as well as the ability to provide clear and concise communicated both verbally and written. This position is empowered to approve, pend or deny services for our population of patients according to policy. This position requires strong knowledge of ICD9/10 diagnosis codes as well as CPT codes.

  • Completes necessary insurance precertifications for all inpatients, complicated surgeries such as HIPEC etc and all outpatient procedures including but not limited high tech imaging, advanced radiation procedures such as Cyberknife and Tomotherapy and all chemotherapy regimens as well as other services requiring authorization. This process includes using on-line evidence-based tools the payers require us to use, completing clinical forms with codes for procedures and diagnosis and obtaining signature from physicians.  Also requires the knowledge to ascertain what clinical from the electronic health record should be included in the auth to ensure a positive outcome for the patient. This part of the job is time-bound as this position requires the stakeholder to work on a deadline as auth must be obtained before the patient can proceed.
  • Continuously monitors email and fax server distribution for incoming pre-cert notifications.  Complete requests and respond to these in a timely and appropriate manner. Escalate and communicate outcome of the authorization to clinicians,
  • Exemplifies excellent customer service skills when communicating with payers, schedulers, nurses, physicians, and staff to provide assistance and support as needed and on request.
  • Thoroughly documents all communication regarding precertification into the electronic record.  Complete all release of information forms and submit to HIM maintaining privacy policies
  • Takes accountability to ensure all precerts are completed to prevent denials of payment. Has minimal to no denials regarding precertification issues.  Work with the payer to resolve any denials that may occur. Manages time and tasks to meet the expectations of the department manager.  Keeps track of productivity on a daily basis.  Demonstrates ability to provide solutions for performance improvement. Participate in improvement projects and departmental KPIs

We win together

Each CTCA employee is a Stakeholder, driven to make a true difference and help win the fight against cancer. Each day is a challenge, but this unique experience comes with rewards that you may never have thought possible. To ensure each team member brings his or her best self, we offer exceptional support and immersive training to encourage your personal and professional growth. If you’re ready to be part of something bigger and work with a passionate, dynamic group of care professionals, we invite you to join us. 

Visit:  Jobs.cancercenter.com to begin your journey.

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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