Work where every moment mattersEvery day over Hartford HealthCare colleagues come to work with one thing in common Pride in what we do knowing every moment matters here We invite you to become part of Connecticutrsquos most comprehensive healthcare networkThe creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole rather than a single member organizationWith the creation of our new umbrella organization we now have our own identity with a unique payroll benefits performance management system service recognition programs and other common practices across the systemPosition SummaryUnder the direction of the Manager Prior Authorization Services HHC Cancer Institute performs all clerical duties required to obtain insurance prior authorizations for chemotherapy and other services in a timely manner Responsible for maintaining and managing resources including insurance portal access and provides consistent documentation in EPIC to support the obtained insurance authorization Communicates changes in payer and or federal regulatory guidelines to their manager pharmacy staff providers and other clinical departments as applicable Position ResponsibilitiesKey Areas of ResponsibilityMonitors and reviews the prior authorization work queue daily to verify accuracy of patientrsquos insurance information and to interpret insurance pre authorization requirements for scheduled chemotherapy treatmentsContacts insurance companies to obtain prior authorization via telephone andor portals and provides necessary clinical documentation to ensure authorization is obtained prior to the scheduled chemotherapy treatmentDocuments in EPIC prior authorization information obtained such as number of treatments authorized length of time treatment is authorized authorization numbers and insurance company contact or call reference numberImmediately communicates to provider and infusion staff when a chemotherapy drug or plan is denied by the insurance company and communicates insurance company drug preference if givenCollaborates and communicates with pharmacy regarding preferred drugs and biosimilars as required by pharmacy and or insurance company and notifies manager of changesMaintains log of missed prior authorizations and assists manager with monthly audit follow up for denialsCollaborates with various hospital departments around billing information management policies procedures and general operations related to prior authorizationsAssists with training of new prior authorization staff and other duties as assignedWorking RelationshipsThis Job Reports To Job Title Manager Prior Authorization Services HHC Cancer InstituteWork where every moment mattersEvery day over Hartford HealthCare colleagues come to work with one thing in common Pride in what we do knowing every moment matters here We invite you to become part of Connecticutrsquos most comprehensive healthcare networkThe creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole rather than a single member organizationWith the creation of our new umbrella organization we now have our own identity with a unique payroll benefits performance management system service recognition programs and other common practices across the systemPosition SummaryUnder the direction of the Manager Prior Authorization Services HHC Cancer Institute performs all clerical duties required to obtain insurance prior authorizations for chemotherapy and other services in a timely manner Responsible for maintaining and managing resources including insurance portal access and provides consistent documentation in EPIC to support the obtained insurance authorization Communicates changes in payer and or federal regulatory guidelines to their manager pharmacy staff providers and other clinical departments as applicable Position ResponsibilitiesKey Areas of ResponsibilityMonitors and reviews the prior authorization work queue daily to verify accuracy of patientrsquos insurance information and to interpret insurance pre authorization requirements for scheduled chemotherapy treatmentsContacts insurance companies to obtain prior authorization via telephone andor portals and provides necessary clinical documentation to ensure authorization is obtained prior to the scheduled chemotherapy treatmentDocuments in EPIC prior authorization information obtained such as number of treatments authorized length of time treatment is authorized authorization numbers and insurance company contact or call reference numberImmediately communicates to provider and infusion staff when a chemotherapy drug or plan is denied by the insurance company and communicates insurance company drug preference if givenCollaborates and communicates with pharmacy regarding preferred drugs and biosimilars as required by pharmacy and or insurance company and notifies manager of changesMaintains log of missed prior authorizations and assists manager with monthly audit follow up for denialsCollaborates with various hospital departments around billing information management policies procedures and general operations related to prior authorizationsAssists with training of new prior authorization staff and other duties as assignedWorking RelationshipsThis Job Reports To Job Title Manager Prior Authorization Services HHC Cancer InstituteRequirements and SpecificationsEducationmiddot High School GraduateDiplomaExperiencemiddot Minimum one year experience working with insurances and prior authorizations preferredKnowledge Skills and Ability Requirements middot Experience and knowledge of insurances and prior authorizationsmiddot Ability to effectively and professionally communicate with physicians clinical and administrative staff managers patients and insurance companiesmiddot Must be self motivated and have the ability to work independently and within a teammiddot Excellent telephone and customer service skillsmiddot Demonstrates excellent computer skillsmiddot Must demonstrate strong organizations skillsWe take great care of careersWith locations around the state Hartford HealthCare offers exciting opportunities for career development and growth Here you are part of an organization on the cutting edge ndash helping to bring new technologies breakthrough treatments and community education to countless men women and children We know that a thriving organization starts with thriving employees we provide a competitive benefits program designed to ensure worklife balance Every moment matters And this isyour momentRequirements and SpecificationsEducationmiddot High School GraduateDiplomaExperiencemiddot Minimum one year experience working with insurances and prior authorizations preferredKnowledge Skills and Ability Requirements middot Experience and knowledge of insurances and prior authorizationsmiddot Ability to effectively and professionally communicate with physicians clinical and administrative staff managers patients and insurance companiesmiddot Must be self motivated and have the ability to work independently and within a teammiddot Excellent telephone and customer service skillsmiddot Demonstrates excellent computer skillsmiddot Must demonstrate strong organizations skillsWe take great care of careersWith locations around the state Hartford HealthCare offers exciting opportunities for career development and growth Here you are part of an organization on the cutting edge ndash helping to bring new technologies breakthrough treatments and community education to countless men women and children We know that a thriving organization starts with thriving employees we provide a competitive benefits program designed to ensure worklife balance Every moment matters And this isyour moment