Eligibility Coordinator

Medical Oncology Associates of San Diego

Medical Oncology Associates of San Diego is a proud partner of One Oncology's network of the nation's leading oncology practices.

Why Join Us? We are looking for talented and highly-motivated individuals who demonstrate a natural desire to support the meaningful work of community oncologists and the patients we serve.

Job Description:

Objective: This position is responsible for verifying patient insurance coverage, obtaining authorizations, and assists in resolving billing related issues. This position bridges the gap between patients, medical staff, and insurance companies to ensure care is covered and claims are processed successfully.

Responsibilities/Essential Functions:

Verify insurance coverage details using established insurance verification processes.

Update coverage at the account level as necessary to prevent denials.

Completes timely, efficient, verification of coverage and eligibility, and obtains authorizations following payer and internal procedures with minimal supervision.

Manage and track patient office visit authorizations from initiation through completion, ensuring all steps are accurately documented.

Maintain comprehensive medical records, including eligibility and authorization documentation, CPT codes, ICD codes, and other relevant medical terminology.

Ensure compliance with HIPAA regulations by safeguarding patient information during all stages of processing.

Assist in resolving any issues related to insurance coverage denials or on authorization delays promptly and professionally.

Promote a positive, inclusive and supportive team culture across all teams, consistently demonstrating professionalism and integrity.

Continuously identifies issues and trends impacting patient care, quality, and timely reimbursement and reports to leadership along with potential solutions.

Meets quality and productivity standards.

*This job description is not designed to cover an exhaustive list of duties. Other duties may be assigned and activities may change any time with or without notice, as applicable. Furthermore, job descriptions do not establish a contract or change the at-will nature of employment.

Experience, Qualifications, Education:

1 year of recent experience working in a medical office setting with knowledge of office procedures, medical terminology, performing insurance registration, coverage and eligibility verification, and obtaining authorizations.

Knowledge of insurance verification processes.

Familiarity with medical coding including CPT and ICD coding standards.

Strong understanding of HIPAA regulations to ensure patient confidentiality at all times.

Ability to multitask efficiently in a fast-paced environment and a capacity to handle high volumes while maintaining attention to detail.

High School Diploma, required

Required Knowledge, Skills, and Abilities:

Excellent verbal and written communication skills.

Proficiency in computer processing functions and other standard office equipment.

Ability to effectively manage and prioritize multiple tasks.

Ability to calmly and professionally resolve issues with diplomacy and tact.

Ability to work independently with minimal supervision.

Strong organizational skills.

Visual acuity to read a computer screen and paper documents; close and distance vision, peripheral vision depth perception, ability to adjust focus.

Hearing acuity to converse with staff and customers in person and by phone.

Ability to stoop, bend, kneel, reach with hands, and lift and move 10 pounds on a regular basis, and up to 25 pounds occasionally; ability to sit for hours at a time.

Working Conditions:

This position functions indoors in a medical/business environment. Employee will be exposed to moderate noise levels and interruptions. Visual acuity to read and compute screen and paper documents; close and distance vision, peripheral vision depth perception, ability to adjust focus; hearing acuity to converse with staff and customers. Ability to sit for hours at a time. Employee will be exposed to moderate noise levels and interruptions.

Travel: Travel between local offices when necessary.

Pay:

$21-$24/hr

Medical Oncology Associates of San Diego AMG, Inc.