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State University of New York Upstate Medical University
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See open jobs at State University of New York Upstate Medical University.See open jobs similar to "Radiation Oncology Authorization and Referral Specialist" This is CNY.The Radiation Oncology Authorization and Referral Specialist is responsible for managing the Radiation Oncology (RO) Epic Work Queue (WQ), which contains ancillary referrals and orders for established patients. These orders are initiated by RO providers and may include diagnostic testing, referrals to oncology specialists (e.g., Medical Oncology, Surgical Oncology, Pulmonology), and supportive specialty services such as palliative care, physical medicine and rehabilitation (PM&R), nutrition, psycho-oncology, and genetic counseling. Key responsibilities include prioritizing STAT and cancer staging orders necessary for timely treatment planning, obtaining insurance authorizations and pre-certifications promptly, and ensuring timely scheduling of services. The RO Authorization and Referral Specialist must maintain expert-level of continued knowledge of insurance carrier policies and authorization/referral requirements, including ongoing monitoring of carrier updates, website access, participation in relevant listservs and Upstate's in-network and out-of-network status with various payors .Will serve as a key resource for lower-level staff, providing guidance on referral, authorization, and scheduling protocols.
Associate's Degree and 3 year relevant experience with patient care administrative functions or equivalent combination of education and experience required. Working knowledge of medical terminology, familiarity with medical coding and excellent written/communication skills required. Ability to multitask in a high volume setting required.
Experience in obtaining insurance authorizations and working with EPIC EMR and Microsoft applications preferred.
M-F 8a-4:30p
Recruitment Office: Human Resources