O R Colan Associates Jobs in Jackson, OH (NOW HIRING)

At UK King's Daughters, we're not just a healthcare facility - we're a family of dedicated professionals who share a passion for making a meaningful difference in the lives of our patients. We're more than just a place to work; we're a place to grow, thrive, and contribute to our community.
Job Description:
Job Summary
Responsible for coordinating insurance authorization and pre-certification for scheduled medications and laboratory tests. Communicates denials to appropriate parties as necessary. Ensures timely and accurate processing of all insurance-related documentation. Collaborates with clinical and administrative teams to support patient care and access. Maintains compliance with regulatory and payer requirements.
Essential Functions
• Tracks, obtains, and extends authorizations in a timely manner.
• Records insurance information using standardized documentation practices.
• Obtains, interprets, and submits clinical documentation for prior authorization.
• Obtains and documents prior authorization approvals from insurance companies.
• Communicates authorization status or delays to providers and clinical staff.
• Follows up on denied authorization requests.
• Facilitates peer-to-peer conversations between insurance carriers and providers.
• Supports claim denial appeal efforts related to prior authorizations.
• Performs other duties as assigned.
Education Requirement
High school diploma or equivalent experience
Experience Requirement
0-2 years of experience in a healthcare, clinical setting, or a relevant area
An equivalent combination of education and experience may be considered.
All experience must be paid and in the same related field.
Part-time and PRN experience will be prorated based on hours worked per week.
Volunteer work and internships for academic credit are not counted.
Certifications & Licensures
N/A
Working Conditions
A. Lifting, pushing, and/or pulling objects up to 50lbs: 2. Occasional (< 10% of the time)
B. Lifting, pushing, and/or pulling objects over 50lbs: 1. Never
C. Standing or walking with objects up to 10lbs: 3. Intermittent (10% - 50% of the time)
D. Standing or walking with objects up to 25lbs: 2. Occasional (< 10% of the time)
E. Sitting at computer workstation for extended periods: 4. Regular (> 50% of the time)
F. Risk of back injury from moving, lifting or positioning patients, equipment, or materials: 1. Never
G. Repetitive motion: 4. Regular (> 50% of the time)
H. Working at heights above 4 feet: 1. Never
I. Working in confined spaces: 1. Never
J. Risk of injuries from use of equipment on the job: 1. Never
K. Job-related travel: 2. Occasional (< 10% of the time)
L. Loud noises: 1. Never
M. Temperature extremes: 1. Never
N. Hazardous chemicals and fumes including waste: 1. Never
O. Radiation: 1. Never
P. Burns: 1. Never
Q. Cuts/Punctures: 1. Never
R. Bloodborne/airborne pathogens: 1. Never
S. Recombinant DNA or viral vectors: 1. Never
T. Combative/violent people: 1. Never
U. Animal handling (including carcasses): 1. Never
V. Please specify other(s) and amount of exposure (i.e. Occasional, Intermittent or Regular): N/A
Physical Demands
This position requires regular sitting at a computer workstation for extended periods of time; performing tasks with repetitive motions (such as typing); intermittent standing or walking with objects weighing up to 10 pounds; and occasional lifting, pushing, and/or pulling of objects weighing up to 50 pounds. Occasional job-related travel may also be required.
Additional Job Descriptions
N/A
Department:
KDIP Oncology Portsmouth
Shift:
Days (United States of America)
Time Type:
Full time
Address:
916 11th Street
City, State:
Portsmouth, Ohio