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Insurance Reviewer in Flower Mound, TX at Volt

Date Posted: 12/6/2018

Job Snapshot

Job Description

Volt Workforce Solutions is looking for an Insurance Reviewer for one of the leading pharmaceutical distributors in North America. After reading the job info below, if interested, email an updated resume (in Word format).

Job Title: Insurance Reviewer 

Location: Flower Mound, TX

Position Summary
Reviews, processes and audits the medical necessity for each patient chemotherapy treatment and documentation of regimen relative to pathway adherence.

Responsibilities
-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.
-Updates coding/payer guidelines for clinical staff. Tracks pathways and performs various other business office functions on an as needed basis
-Obtains insurance authorization and pre-certification specifically for chemotherapy services. Works as a patient advocate and functions as a liaison between the patient and payer to answer reimbursement questions and avoid insurance delays.
-Researches additional or alternative resources for non-covered chemotherapy services to prevent payment denials. Provides a contact list for patients’ community resources including special programs, drugs and pharmaceutical supplies and financial resources.
-Maintains a good working knowledge of chemotherapy authorization requirements for all payers, State and federal regulatory guidelines for coverage and authorization. Adheres to confidentiality, state, federal, and HIPPA laws and guidelines with regards to patients’ records.

As a Volt employee, you can expect the highest level of support.  We have a long-standing tradition of developing lasting and mutually beneficial relationships with our employees.  Contact a Volt representative by applying to this posting online for immediate consideration. Submit your resume today! To learn more about Volt, please visit: http://www.volt.com and to see more of our job postings, please visit: http://jobs.volt.com

Volt is an Equal Opportunity Employer.

Pay Rate is based on experience.