Authorization Representative - Oncology

• High School diploma or equivalent. Associate degree in finance or business administration highly desirable.

• Four or more years of prior work experience in patient registration, patient accounting and knowledge of third party payors.

• Familiarity with medical terminology and concepts.

• Working knowledge with third party insurance verification, respective systems, authorization, referral procedures and clinical care process internal and external.

• Comprehensive knowledge of patient access process.

• Working knowledge of Michigan based Managed Care programs.

Skills Required

• Ability to understand and apply various third party payor requirements, verifications procedures and insurance benefit knowledge.

• Strong customer service orientation skills necessary to deal effectively with various levels of hospital staff, to communicate with diverse populations, and to relay sensitive and confidential information to patients, internal staff and a variety of external organizations.

• Excellent verbal and people skills; strong face-to-face communicator.

• Ability to work as a team with clinical staff as well as business office and payer staff.

• Ability to manage multiple tasks and organize appropriately.

• Analytical skills necessary to calculate patient liability, income status and solve problems related to credit and collection matters.

• Communication and/or interpersonal skills for contact with internal and external customers/stakeholders to discuss and interpret technical information and department or function policy. Some discretion must be exercised in deciding what and how to communicate. Conflict resolution skills are exercised within the unit or function and occasionally on an interdepartmental or interfunctional basis. Diplomacy, tact and listening skills are required.

• Ability to read and comprehend policies and interpret technical materials in the specialty area is necessary.

• Proficient in the use of computers, database programs and a variety of computer spreadsheet programs.

Facility Description:

DMC Huron Valley-Sinai Hospital in Oakland County is committed to outstanding customer service and medical care. This hospital features the Harris Birthing Center with all private birthing suites, the Charach Cancer Treatment Center (affiliated with the Barbara Ann Karmanos Cancer Center), cardiac services, and comprehensive inpatient and outpatient diagnostic care. For emergency services, obstetrics and ambulatory surgery, Huron Valley-Sinai consistently ranks among the top hospitals in the nation.

EEO Statement

Employment practices will not be influenced or affected by an applicant’s or employee’s  race, color, religion, sex (including pregnancy), national origin, age, disability, genetic  information, sexual orientation, gender identity or expression, veteran status or any other  legally protected status. 

Tenet will make reasonable accommodations for qualified  individuals with disabilities unless doing so would result in an undue hardship.

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JOIN OUR TEAM

 QUALITY CARE DELIVERED BY COMPASSIONATE PEOPLE

We know it takes a special person to work in healthcare, and we are committed to providing our people with an enriching and rewarding environment. We deliver the resources, tools and support our employees need to serve our patients and customers in the best way possible — so we can create happier, healthier communities. 

COMMITTED TO DIVERSITY AND INCLUSION

At Tenet, we believe in a diverse and inclusive environment, one that is grounded in our dedication to the health and well-being of all people. Respecting, nurturing and encouraging diversity of thought, background and experience contribute to positive work environments that result in exceptional patient care. We embrace diversity because it's our culture, and because it's the right thing to do.

Embark on a rewarding career with DMC Huron Valley-Sinai Hospital. If you are a compassionate healthcare professional eager to contribute to patient care, this is your opportunity where your skills make a difference every day. Join us in delivering exceptional healthcare with a personal touch. 

Benefits Statement 

At Tenet Healthcare, we understand that our greatest asset is our dedicated team of  professionals. That’s why we offer more than a job – we provide a comprehensive benefit  package that prioritizes your health, professional development, and work-life balance. The  available plans and programs include\:  
• Medical, dental, vision, and life insurance
• 401(k) retirement savings plan with employer match
• Generous paid time off (PTO)  
• Career development and continuing education opportunities  
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness  insurance, long term care, elder & childcare, auto & home insurance.

Note\: Eligibility for benefits may vary by location and is determined by employment status

Job Summary

Under general supervision is responsible for securing and tracking authorizations/referrals through patient's length of stay or visit. Assures authorizations/referrals and re-authorizations are obtained and secured for hospital and clinic patients. Participates in the care and customer service process by ensuring all authorizations have been received. Assures appropriate verified insurance information has been updated in SMS registration pathways to ensure timely payment and to meet clean claim requirements. Coordinates with outside eligibility vendor and Clinical Resource Management as necessary using established criteria. Obtains financial approvals and supporting documentation for internal financial assistance programs, updates the registration pathways with approval or denial information. Interprets Managed Care contracts and other third party payer contacts in order to secure correct authorization and/or referral. Downloads and updates Dedicated Authorization log on a daily basis. Provides various reports to management.