Cancer Center Therapeutic Pre Cert Counselor- Chemotherapy Suite Union Square- Full Time Days

The Cancer Center/Therapeutic pre-certification counselor is responsible for insurance verification obtaining authorization for all services and calculation and patient notification of co-insurance co-payments and deductible for all treatment plans and services provided for patients of the Cancer Center and Therapeutic Programs

and verifies patient demographic and insurance information and updates all requires systems to ensure all have correct information. hospital visits/services which require a referral and obtains the required referral from provider

authorization for all services procedures and treatments being provided in the Centers prior to the requested treatment start date. Authorizations are to be obtained online via the payer/vendor web portal when available or via phone /fax.

part of the authorization process verifies medical necessity of the CPT/HCPCS codes being ordered via the CMS or payer web site or via the drug website. Off-label treatments need to be identified prior to treatment being started

required reaches out to the clinical team to obtain a letter of medical necessity which might be required to obtain an authorization for the services/treatments being requested.

clinical team scheduling team and patient of any delays in financial clearance which might delay their treatment start date.

the patients co-pay co-insurance and/or deductible for the services being rendered/requested and notify the patient of their self-pay responsibility prior to the treatment start date. For eligible patients refer the patient information

communicates to the patient their financial obligations prior to treatment and answers any questions they might have regarding the billing process or refers the patients to a Supervisor for assistance

applicable refers patient over to the Medicaid Application Team so they can assist patient with obtaining insurance coverage. Epic Cerner IDX Eagle and the On-Trac system to document financial clearance status and patient respons

-trained to support all service lines treatments and payers. up to date on all new treatment plans and drugs and what is required to financially clear these new treatments

is varied to meet the needs of the service sites and ancillary departments. projects as assigned by supervisor or manager

projects as assigned by supervisor or manager

• HS/GED; Associates Degree preferred
• Prior insurance verification or precertification experience; or Hospital or Physicians Office billing experience required.

Collective bargaining unit: SEIU 1199-MSBI

Compensation Statement

The Mount Sinai Health System (MSHS) provides salary ranges that comply with the New York City Law on Salary Transparency in Job Advertisements. The salary range for the role is $31.40 - $31.93 Hourly. Actual salaries depend on a variety of factors including experience education and operational need. The salary range or contractual rate listed does not include bonuses/incentive differential pay or other forms of compensation or benefits.

SEIU 1199 at Mount Sinai Beth Israel and MS Downtown AKS - Chemotherapy Suite - USD Union Square - Downtown