Company: Mount Auburn Hospital
Posted on: October 19, 2020
MOUNT AUBURN HOSPITAL - CAMBRIDGE, MA
Principal Duties and Responsibilities
1. Responsible for researching and pre authorizing cancer services
before they are provided working with various parties such as
insurers, pharmaceutical companies and the MAH Radiology, Lab,
Pharmacy and Finance Departments.
2. Conducts prior authorization for all pre medications, primary
chemotherapy drugs and supportive drugs. This involves research
into the Medicare system, utilizing off label drug compendiums and
direct authorization work with patient primary and secondary
insurers. Will require close interaction with Department
physicians, mid level practitioners, nurses and medical
3. Receives written prescriptions or requests for prescription
refills from patients and verifies that the information on the
prescription is complete and accurate.
4. Develops and maintains effective relations with physician office
5. Perform routine communication as needed to adequately assure
results are reported accurately and timely.
6. Responsible for answering phones, insurance verification and
eligibility, pre-certification and securing authorization for
inpatient and outpatient services, self pay, commercial, and
Medicare or third party reservations.
7. Process all required paperwork according to established
KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED
1. High School graduate, Associates Degree preferred. Related
Medical/Technical degree desirable.
2. Minimum of three years experience in a Hematology Oncology
environment with exposure to the patient population and the types
of services patients receive. Coding and prior authorization
experience involving oncology drugs and ancillary testing
3. Medical coding desirable
4. Strong communication skills required
5. Knowledge of medical terminology, medical insurance, covered
services and those that require prior authorization. Knowledge of
oncology services, drug regimens and associated regulations.
Mount Auburn Hospital is a tobacco-free campus. We are an equal
opportunity employer and we offer wonderful opportunities for
advancement, so you re sure to find a position that suits your
unique skills here.
We value equality and are committed to maintaining an environment
in which employees, patients, and visitors are treated without
regard to their race, color, religion, national origin, age, sex,
handicap, veteran s status, sexual orientation, gender identity or
Keywords: Mount Auburn Hospital, Cambridge , Authorization Specialist, Other , Cambridge, Massachusetts
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