Oncology Authorization Specialist

About

Plutus Health Inc. is a healthcare revenue cycle management firm that has been in the industry for 15 years. We offer end-to-end business solutions to healthcare providers in the United States, ensuring that all our services are fully compliant with HIPAA regulations. Our team has extensive experience in the field, and we leverage cutting-edge technology to ensure that your medical billing and collections processes run smoothly.

Along with being SOC-certified and HIPPA-compliant, we have:

• Full-Cycle RCM: We handle everything from medical coding and credentialing to denial management and patient collections.
• Tech-Driven Efficiency: Our team of 1000+ experts, each with their unique expertise, is backed by 70+ RPA bots for automation, ensuring accuracy and speed.
• Flexibility: We offer billing software, financial dashboards, and patient portals, and we integrate seamlessly with your existing systems.

We have Centers of Excellence worldwide to effectively serve your needs, with our headquarters located in Dallas.

Life at Plutus Health

Plutus Health offers an unique work environment that is both thrilling and enriching, fostering personal and professional growth. Our company is a hub of innovation, collaboration, and continuous learning, where we encourage our employees to adopt a positive mindset and strive for excellence.

At Plutus Health, you'll be part of a vibrant team that thrives on creativity and problem-solving. You'll have the chance to work on cutting-edge projects, harnessing the latest technologies and methodologies to deliver intelligent solutions that make a real difference for our clients.

Plutus Health prioritizes the well-being of its employees and fosters a supportive and inclusive culture that promotes work-life balance. If you are enthusiastic about joining a vibrant organization that values your input, Plutus Health is the ideal place to pursue your career goals.

Job Title: Oncology Authorisation Specialist

Report To: Team Leader

Experience: 1 - 5 Years

Qualification: PUC

Location: Bangalore / Coimbatore

Shift Time: 09:00 AM - 06:00 PM

Mode: Work from office

Terms-Fulltime/Part time/Contractual: Full-Time

Job Summary

As an Oncology Authorization Specialist, you will be crucial in obtaining and managing authorizations for oncology-related treatments and procedures. This position requires a deep understanding of insurance protocols, Clinical questions, and oncology treatment processes.

Key Responsibilities

• Obtain pre-authorization for complex oncology treatments, medications, and procedures from insurance providers (Chemo Drugs).
• Demonstrate proficiency in understanding and navigating various oncology regimens, drugs, and dosages.
• Collaborate with healthcare providers, physicians, and insurance companies to ensure timely authorization approvals.
• Verify insurance coverage and communicate with patients regarding authorization status and any potential financial responsibilities.
• Maintain accurate and up-to-date records of authorization requests, approvals, and denials.
• Stay informed about changes in insurance policies, coding regulations, and reimbursement processes related to oncology services.
• Utilize and navigate authorization portals like Carelon, Evicore, Optum, Availity, etc., to streamline the authorization process.

Mandatory Skills

• Excellent communication and interpersonal skills.
• Detail-oriented with the ability to manage multiple tasks simultaneously.
• Proficient in using NextGen & Epic.

Desired skills

• Minimum of [2] years of experience in oncology authorization or a similar role.
• Strong knowledge of RCM, insurance procedures, and oncology treatment processes.