Astera

Role Description Responsible for collaborating with healthcare providers and members to optimize member benefits and to promote effective use of financial resources available. Assesses the medical necessity of chemotherapy treatment and non-chemotherapy treatment. Conducts pre-certification, concurrent and retrospective reviews to ensure compliance with medical policy, member eligibility, benefits, and patient’s financial capability. This position is remote within New Jersey. - Performs pre-certification and related duties to secure authorization for payment for treatment from insurance companies, drug companies, foundation resources, and patients. Oncology experience a plus. - Verification of patients’ benefits and eligibility for pre-certs. - Verification that the diagnosis codes entered in the treatment plan are covered for the drug entered by comparing to insurance company policies and/or NCCN website. - Contacts with insurance company if treatment is approved for the diagnosis entered. - Entry of benefits provided by the insurance representative in Centricity (practice management system) along with the contact’s name and reference number for the call. - Once the benefits are verified, task the treatment scheduler, place treatment and expiration date in billing notes, note appointment note in OncoEMR (PC/GK). - Re-precertification of services, as necessary. It is the sole responsibility of this position to handle for all assigned areas. - Coordinate referral out for treatments if the situation dictates. - Follow all policy and procedure set by Astera Cancer Care to correct any insurance issues before patient has treatment in the office. - Communication with patients regarding deductibles and out of pocket costs. - Patient responsibility will be calculated during benefits verification/pre-certification process. - If qualified, coordinate enrollment in drug programs, foundations, for assistance out of pocket costs for drugs, co-pays, etc. - Utilize online methods for enrollments for greater efficiency. Qualifications - High School Diploma required. - At least one year of experience in the medical insurance field, Oncology preferred. - Prior work experience with insurance precertification and/or financial counseling. - Knowledge of Hematology/Oncology practice operations preferred. - Knowledge of CPT-4, ICD-10, and HCPCS required. - Computer proficiency including the ability to utilize software programs used by the organization: Candid, G4/Centricity, Flatiron/OncoEMR, Annexus/Assistpoint, insurance websites. Requirements - This position is remote within New Jersey. Benefits - Comprehensive benefit package and paid time off. - Immediate eligibility for medical, dental, vision, life, disability, HSA, FSA, and other ancillary benefits. - 401(k) plan with company contribution. - Profit sharing. - Tuition assistance. - Employee referral bonus.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description Collaborate with pharmaceutical companies, reimbursement representatives, Astera staff and patients to optimize member benefits and to promote effective use of financial resources available for patient financial assistance. Assess patient need for financial assistance, and verify patient requirement criteria for grants, patient assistance programs and copay card programs. - Work closely with the precert and billing department to procure financial assistance for Astera patients. - Use Annexus Health/AssistPoint platform to submit benefit verification applications, enroll patients with copay card programs integrated with Assist Point, and assist patients with securing medications at no cost. - Use Analytics to run multiple reports and identify potential financial assistance opportunities for Astera patients. - Use Astera’s practice management software, Candid, G4/Centricity, to perform copay card data entry, review precert/billing notes and update copay card information as needed. - Use OncoEMR to gain a better understanding of the drugs/treatments that are ordered for the patients. Review drug indications and valid and appropriate coding required to complete patient applications. - Shadow the precertification team and focus on the process for a better understanding of the importance of the financial assistance role and how it relates to the department’s workflow. - Communicate with office staff to obtain patient and physician signatures. Communicate with patients to obtain financial and household information for completion of application process. - Communicate with pharmaceutical reimbursement representatives, foundations and pharmaceutical companies to identify available funding and secure financial assistance for Astera patients. - Submit drug prescription forms and relay prescription details to pharmacist when necessary to expedite the approval process. Coordinate initial delivery of medications while simultaneously coordinating with the precert team and chemo scheduler to ensure delivery. - Must demonstrate computer proficiency with various programs/applications such as Candid/G4/Centricity, Flatiron/OncoEMR, Annexus/Assistpoint, insurance websites. Qualifications - High School Diploma required. - At least one year of experience in the medical insurance field, oncology preferred. - Prior work experience with patient enrollments for financial assistance preferred. Requirements - Excellent verbal and written communication skills to explain the financial assistance process to our patients, as well as the financial requirements and documentation foundations and pharma require. - Ability to communicate with all levels of staff, physicians, patients, foundations and pharmaceutical representatives. - Ability to manage multiple priorities in a fast-paced practice environment. - Must be well-organized and practice good time management skills. - Must have the ability to prioritize, make decisions and work independently in a remote work environment. - Knowledge of Hematology/Oncology practice operations preferred. - Knowledge of CPT-4, ICD-10, and HCPCS required. Benefits - Comprehensive benefit package and paid time off. - Immediate eligibility for medical, dental, vision, life, disability, HSA, FSA and other ancillary benefits. - 401(k) plan with company contribution. - Profit sharing. - Tuition assistance. - Employee referral bonus. Work Location This position is remote within New Jersey.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description Responsible for collaborating with healthcare providers and members to optimize member benefits and to promote effective use of financial resources available. Assesses the medical necessity of chemotherapy treatment and non-chemotherapy treatment. This position is remote within New Jersey. - Performs pre-certification and related duties to secure authorization for payment for treatment from insurance companies, drug companies, foundation resources, and patients. - Oncology experience a plus. - Verification of patients’ benefits and eligibility for pre-certs. - Verification that the diagnosis codes entered in the treatment plan are covered for the drug entered by comparing to insurance company policies and/or NCCN website. - Contacts with insurance company if treatment is approved for the diagnosis entered. - Entry of benefits provided by the insurance representative in Centricity (practice management system) along with the contact’s name and reference number for the call. - Once the benefits are verified, task the treatment scheduler, place treatment and expiration date in billing notes, note appointment note in OncoEMR (PC/GK). - Re-precertification of services, as necessary. It is the sole responsibility of this position to handle for all assigned areas. - Coordinate referral out for treatments if the situation dictates. - Follow all policy and procedure set by Astera Cancer Care to correct any insurance issues before patient has treatment in the office. - Communication with patients regarding deductibles and out of pocket costs. - Patient responsibility will be calculated during benefits verification/Pre-certification process. - If qualified, coordinate enrollment in drug programs, foundations, for assistance out of pocket costs for drugs, co-pays, etc. - Utilize online methods for enrollments for greater efficiency. Qualifications - High School Diploma required. - At least one year of experience in the medical insurance field, Oncology preferred. - Prior work experience with insurance precertification and/or financial counseling. - Knowledge of Hematology/Oncology practice operations preferred. - Knowledge of CPT-4, ICD-10, and HCPCS required. - Computer proficiency including the ability to utilize software programs used by the organization. - Candid, G4/Centricity, Flatiron/OncoEMR, Annexus/Assistpoint, insurance websites. Requirements - This position is remote within New Jersey. Benefits - Comprehensive benefit package and paid time off. - Immediate eligibility for medical, dental, vision, life, disability, HSA, FSA, and other ancillary benefits. - 401(k) plan with company contribution. - Profit sharing. - Tuition assistance. - Employee referral bonus.