Kettering Health Network Job - 37251679 | CareerArc
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Company: Kettering Health Network
Location: Kettering, OH
Career Level: Associate
Industries: Healthcare, Pharmaceutical, Biotech

Description

 

Kettering Health is a not-for-profit network of nine hospitals, Kettering College, and over 160 outpatient facilities serving southwest Ohio. Patients have access to high quality maternity care, state-of-the-art cancer fighting technology, Ohio's leading heart hospital, as well as revolutionary brain and spine surgery. With nearly 14,000 employees and 2,100 physicians, Kettering Health is committed to transforming the healthcare experience with world class health services for every stage of life. 
 
Kettering Health recently celebrated the 50th anniversary of Kettering Medical Center. 
 

As a faith-based organization we are dedicated to treating all patients with love and respect regardless of religious preference. Multi-denominational Spiritual Services are offered at the network every day. 

 



Requirements

This position is responsible for the authorizations for all chemotherapy/infusion services at Kettering Cancer Care. This role will obtain accurate and timely decisions from payers regarding authorizations of chemotherapy, infusion, injection therapy and any other procedure requiring authorization on the Grandview infusion floor.  This position requires excellent time management and organizational skills as well as the ability to provide clear and concise communication, 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

The employee communicates with nursing and medical staff to inform them of any restrictions or special requirements in accordance with insurance plans. He/she provides prompt feedback to physicians and management regarding any payer issues with non-covered chemotherapy/infusion drugs. He/she uses the EPIC/Beacon work que and referral entry to maintain all new authorizations and expiring authorizations. 

 

Job Requirements:

  • High School diploma required. 
  • Complies with patient confidentiality laws and regulations
  • Minimum one year oncology experience, medical terminology knowledge and strong computer skills required. Attention to detail, ability to discuss delicate matters in pleasant and professional manner required.
  • He/she maintains a good working knowledge of chemotherapy authorization requirements for all payers, State and federal regulatory guidelines for coverage and authorization.


Qualifications

Preferred Qualifications:

  • A.D. in Business or health related field preferred.
  • Oncology coding and billing experience preferred.


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