Dana-Farber Cancer Institute
Brookline, MA
The Radiation Oncology Authorization Specialist is responsible for independently coordinating and managing medical necessity-based prior authorizations for radiation oncology services. Working in a high-volume, fast-moving environment, the Radiation Oncology Authorization Specialist applies payer coverage criteria and authorization requirements to ensure financial clearance for radiation oncology services prior to key milestones (consult, CT simulation, treatment start) by reviewing the electronic medical record (EMR) and other aligned tools to compile relevant clinical information. The Specialist also monitors pending cases, addresses payer requests for additional information, and helps coordinate next steps for denials, peer-to-peer reviews, and appeals to reduce delays in patient care. By partnering closely with Radiation Oncology operations, clinicians, scheduling, coding/billing, Patient Financial Services, and payers, the Specialist actively works to reduce delays in care,...
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Medical Imaging
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