Authorization Spec

Rocky Mountain Cancer Centers, Colorado's largest and most comprehensive provider of cancer care has an exciting opportunity for an experienced Authorization Specialist in Greenwood Village, CO.

We realize that it sounds cliche but it is true - taking care of cancer patients is a calling. It's much more than a job. Each of us has a unique story that brought us to Rocky Mountain Cancer Centers (RMCC), but those stories usually share common themes of care, compassion, and commitment.

No matter the role each RMCC team member serves in, the goal is the same: to provide the best care possible for each and every one of our patients. Whether we are a nurse holding our patient's hand, or a scheduler on the phone finding an appointment that fits into a patient's schedule, we are deeply connected to our patients and do what we can to help.

If this sounds like you, we'd love to have you join our team.

-Reviews, processes and audits the medical necessity for each patient chemotherapy treatment and documentation of regimen and pathway adherence.
-Works as a patient advocate and functions as a liaison between the patient and payer to answer routine and complex inquires reimbursement questions and avoid insurance delays. Obtains insurance authorization and pre-certification for chemotherapy services. Researches additional or alternative resources for non-covered services to prevent payment denials. Provides a contact list for patients community resources including special programs, drugs and pharmaceutical supplies and financial resources.
-Communicates with nursing and medical staff to inform them of any restrictions or special requirements in accordance with particular insurance plans. Provides prompt feedback to physicians and management regarding pathway documentation issues, and payer issues with non-covered chemotherapy drugs.
-Prepares and submits write-off requests with appropriate documentation.
-Processes insurance/patient correspondence, including denial follow-up. Maintains reimbursement correspondence and filing systems. Reviews and processes adjustments and refund requests. Assists with review of financial disclosures and negotiated agreement adjustments. Provides coverage for Patient Financial Counselors. Reports any problems, issues or payer trends.
-Maintains a good working knowledge of chemotherapy authorization requirements for all payers, State and federal regulatory guidelines for coverage and authorization. Complies with patient confidentiality laws and regulations.

Salary Range: $18.29-$24.00

Pay is based on several factors including but not limited to education, work experience, certification, etc. As of the date of this posting, in addition to your salary, RMCC offers the following benefits for this position, subject to eligibility requirements: Health, dental, and vision plans; wellness program; health savings account; flexible spending accounts; 401(k) retirement plan; life insurance, short-term disability insurance; long-term disability insurance, Employee Assistance Program; PTO, holiday pay, tuition reimbursement, and employee paid critical illness and accident insurance

MINIMUM QUALIFICATIONS: Nurse Practitioner Masters of Science in Nursing (MSN) from an accredited nursing school and successful completion of a Nurse Practitioner program. This position typically requires a minimum of 3 years of experience as a practicing Nurse Practitioner, preferably in the chosen specialty. RN state licensure and current registration with the State Board of Nursing in practicing state. Current state licensure as a Nurse Practitioner. AOCNP preferred. Current basic life support (BLS)/CPR certification required.

OR

Physician Assistant Successful completion of an accredited Physician Assistant program. Current NCCPA (National Commission on Certification of Physician Assistants) certification. This position typically requires a minimum of 3 years of experience as a practicing Physician Assistant, preferably in the chosen specialty. Current state license as a Physician Assistant in practicing state. Current basic life support (BLS)/CPR certification required. OR Clinical Nurse Specialist Masters of Science in Nursing (MSN) from an accredited nursing school and successful completion of a Clinical Nurse Specialist program. This position typically requires a minimum of 3 years of practicing Clinical Nurse Specialist, preferably in the chosen specialty. RN state licensure and current registration with the State Board of Nursing in practicing state. Current state licensure as a Clinical Nurse Specialist. AOCNS preferred (if applicable). Current basic life support (BLS)/CPR certification required.

PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination. Requires standing and walking for extensive periods of time. Occasionally lifts and carries items weighing up to 40 lbs. Requires corrected vision and hearing to normal range.

WORK ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations and other conditions common to an oncology/hematology clinic environment.

All qualified candidates are required to pass a background check and non-federal drug test (which excludes marijuana) post offer of employment and prior to hire.

This job posting will remain open until we have identified an adequate applicant pool. Applicants are strongly encouraged to apply early. To apply for this position, start the process by clicking the blue "apply" button.