At Memorial Sloan Kettering (MSK), we're not only changing the way we treat cancer, but also the way the world thinks about it. By working together and pushing forward with innovation and discovery, we're driving excellence and improving outcomes. For the 28th year, MSK has been named a top hospital for cancer by U.S. News & World Report. We are proud to be on Becker's Healthcare list as one of the 150 Great Places to Work in Healthcare in 2018, as well as one of Glassdoor's Employees' Choice Best Place to Work for 2018. We're treating cancer, one patient at a time. Join us and make a difference every day.
Hours: 9 am-5 pm (Monday to Friday)
* Providers of compassionate, evidence-based nursing care to Oncology patients and families living with cancer in a healing and innovative environment.
* Action-oriented and eager to embrace new opportunities and tough challenges with a sense of urgency, high energy, and enthusiasm.
* A good decision-maker, with proven success at making timely decisions that maintains high standards of patient care within the organization.
* Actively seeking new ways to grow and be challenged, using both formal and informal development.
* Approachable and comfortable with diverse groups of people and able to make others comfortable with you.
* An effective communicator, capable of determining how best to reach different audiences and executing communications based on that understanding.
* Capable of building strong customer relationships and delivering customer-centric care solutions.
* Interfaces with insurance carriers, review organizations and MSKCC billing departments to facilitate authorizations for treatment for the inpatient population.
* Coordinates retrospective reviews with insurance contacts.
* Obtains clinical information from medical records and clinical information systems, to meet the request for concurrent and retrospective clinical review from utilization review departments.
* Accesses multiple resources to provide accurate clinical information that will support reimbursement for services rendered by the facility and MSKCC staff.
* Provide clinical information as per Case Management policies maintaining HIPPA compliance.
* Bachelor's degree in Business/ Healthcare Administration
* 2-4 years in healthcare setting, experience with insurance industry and/or experience in reading and interpreting medical records strongly preferred
* Managed Care/Insurance utilization experience preferred
* Excellent interpersonal, problem solving and communication skills
* Knowledge of Microsoft: Outlook, Word, Excel and Internet Explorer.
* Knowledge of Allscripts/ACM preferred
MSK is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sexual orientation, national origin, age, religion, creed, disability, veteran status or any other factor which cannot lawfully be used as a basis for an employment decision.
Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment.
Associated topics: business development, development, manage, office manager, plan, program development, program management, project development, project management, resource development