United States onlyOneOncology is positioning community oncologists to drive the future of cancer care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer. Our team is bringing together leaders to the market place to help drive OneOncology’s mission and vision.
Why join us? This is an exciting time to join OneOncology. Our values-driven culture reflects our startup enthusiasm supported by industry leaders in oncology, technology, and finance. We are looking for talented and highly-motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of community oncologists and the patients they serve.
Job Description:
The RCM Authorization Supervisor will be responsible for managing the daily RCM authorization operations. The individual will need to have expertise in insurance authorizations, coverage and benefits, reimbursement processes and regulations related to Oncology services. The successful candidate will collaborate closely with patients, physicians, and insurance companies to ensure that KPIs are met, and clients are satisfied with the services rendered.
Role Responsibilities
Oversees the day-to-day operations and supervision of the Authorization team including drug, imaging, surgery, and radiation oncology.
Routinely reviews and communicates payer authorization guideline revisions, including step therapy requirements, policy changes and decision trees to the Authorization staff.
Communicates with physician/clinical staff on escalated reimbursement issues and/or off label drug usage utilizing guidelines set forth by the patient’s insurance.
Oversee the orientation and training of new employees and can provide on-site training as needed.
Provides expertise and guidance to the authorization staff.
Develops policy and procedures ensuring best practice.
Manage employee relations issues including hiring, discipline, coaching and performance evaluations.
Maintains open communication with other RCM Leadership and Clinical staff.
Provide backup clinic coverage assistance as needed to the Authorization Specialists.
Routinely communicates with RCM leadership, escalating issues as necessary.
Other duties assigned are to help drive our mission of improving the lives of everyone living with cancer.
Stay current with industry trends, changes to insurance policies, and other developments that may impact on the collections process.
Monitors and assesses business metrics to refine processes and improve efficiencies including benchmarking. Prepare reports for clients and leadership related to performance and productivity.
Prepare payroll records and maintain employee attendance/audits for HR payroll processing.
Manage employee activity such as hiring, job performance, evaluations, and disciplinary actions with appropriate approvals as required
Lead team meetings and prepare minutes for distribution to team and management
Other duties as requested and assigned by management
Qualifications
Extensive knowledge of insurance payer guidelines and medical policies.
Knowledge of ICD10, CPT and HCPCS codes required.
Strong technical skills in Microsoft Office Suite (Word, Excel, PowerPoint).
Associates degree or equivalent experience required.
3+ years of experience in a community oncology setting preferred.
5+ years of RCM healthcare experience required including authorizations.
4+ years of supervisor’s preferred experience.
