• Answering inbound phone helping individuals in understanding their coverages and selecting the right products, services • Making outbound calls to follow up with customers • Demonstrating compassion when assisting individuals • Building customer relationships, earning their loyalty and trust • Assist with workflow of applications for Medicare consideration answering questions as it relates to policies

• Answering inbound phone helping individuals in understanding their coverages and selecting the right products, services • Making outbound calls to follow up with customers • Demonstrating compassion when assisting individuals • Building customer relationships, earning their loyalty and trust • Assist with workflow of applications for Medicare consideration answering questions as it relates to policies

• Lead critical, high-impact client escalations from initiation through closure, ensuring containment, clarity, and complete resolution. • Serve as the single point of accountability for escalation resolution, coordinating cross-functional response teams across Engineering, Delivery, Operations, and Client Success. • Provide structured escalation management, including clear recovery plans, ownership assignments, and communication cadences. • Facilitate daily or weekly stand-ups, executive briefings, and client updates for active escalations. • Drive structured Root Cause Analysis (RCA) and Corrective and Preventive Action (CAPA) for all major client incidents. • Embed quality management practices in every stage of escalation handling, ensuring data-driven and sustainable resolutions. • Partner with Product, Service Delivery, and Quality teams to identify recurring issues and integrate findings into the AHEAD Quality Management System (QMS). • Lead post-incident reviews and “lessons learned” sessions to strengthen AHEAD’s quality culture and client assurance model. • Identify systemic challenges, process gaps, and improvement opportunities across escalation management and service delivery. • Collaborate with the Continual Improvement and Operational Excellence teams to enhance Client Assurance processes, tools, and frameworks. • Develop and execute improvement plans aligned with AHEAD’s CX Quality Objectives, measuring outcomes through defined KPIs (e.g., time-to-resolution, CSAT, recurrence rates). • Promote knowledge sharing, best practices, and proactive risk mitigation across teams to prevent future escalations. • Act as a trusted advisor and advocate for clients, ensuring transparent, empathetic, and outcome-oriented communication throughout the resolution process. • Represent client perspectives in internal governance meetings and improvement forums. • Reinforce client trust by ensuring accountability, responsiveness, and continuous follow-up until full closure. • Track and analyze escalation performance metrics including time-to-resolution, RCA completion, and post-resolution client satisfaction. • Prepare and present executive summaries and performance insights to leadership and governance boards. • Ensure alignment with AHEAD’s Client Assurance Program, Quality, and Service Excellence standards. • Contribute to quarterly and annual program reviews to highlight systemic improvements and quality outcomes.

Role Description The US Oncology Network is looking for an Insurance Authorization Specialist to join our team at Texas Oncology. This full-time remote position will support the Oncology Department at our 2410 Round Rock Avenue #150 clinic in Round Rock, Texas. Typical work week is Monday through Friday, 8:00a - 5:00p. Note from Hiring Manager: Great benefits - opportunity to grow. This position will be either a level 1 or Sr based on candidate work experience. As a part of The US Oncology Network, Texas Oncology delivers high-quality, evidence-based care to patients close to home. Texas Oncology is the largest community oncology provider in the country and has approximately 530 providers in 280+ sites across Texas. Our mission is still the same today—at Texas Oncology, we use leading-edge technology and research to deliver high-quality, evidence-based cancer care to help our patients achieve “More breakthroughs. More victories.”® in their fight against cancer. What does the Insurance Authorization Specialist do? (including but not limited to) - Under general supervision, reviews chemotherapy regimens in accordance to reimbursement guidelines. - Obtains necessary pre-certifications and exceptions to ensure no delay in reimbursement of treatments. - Researches denied services and alternative resources to pay for treatment. - Supports and adheres to the US Oncology Compliance Program, including the Code of Ethics and Business Standards. Qualifications - Level 1: - High school degree or equivalent. - Associates degree in Healthcare, LPN state license and registration preferred. - Minimum three (3) years medical insurance verification and authorization preferred. - Level Sr (in addition to level 1 requirements): - Minimum three (3) years medical insurance verification and authorization. - Two (2) years clinical review experience required. Requirements - Uses Technical and Functional Experience: Possesses up to date knowledge of the profession and industry; regarded as an expert in the technical/functional area. - Demonstrates Adaptability: Handles day to day work challenges confidently; willing and able to adjust to multiple demands, shifting priorities, ambiguity and rapid change. - Uses Sound Judgment: Makes timely, cost effective and sound decisions; makes decisions under conditions of uncertainty. - Shows Work Commitment: Sets high standards of performance; pursues aggressive goals and works efficiently to achieve them. - Commits to Quality: Emphasizes the need to deliver quality products and/or services; defines standards for quality and evaluates products, processes, and service against those standards. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is required to be present at the employee site during regularly scheduled business hours and regularly required to sit or stand and talk or hear. - Requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination. - Requires standing and walking for extensive periods of time. - Occasionally lifts and carries items weighing up to 40 lbs. - Requires corrected vision and hearing to normal range. Work Environment The work environment may include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations and other conditions common to an oncology/hematology clinic environment. Work will involve in-person interaction with co-workers and management and/or clients. Work may require minimal travel by automobile to office sites.