Senior Coordinator, Benefits and Authorization

What Revenue Cycle Management (RCM) contributes to Cardinal Health

Practice Operations Management oversees the business and administrative operations of a medical practice.

Revenue Cycle Management manages a team focused on a series of clinical and administrative processes that healthcare providers utilize to capture, bill, and collect patient service revenue. The revenue cycle shadows the entire patient care journey and begins with patient appointment scheduling and ends when the patient’s account balance is zero.

Benefits and Authorization Coordinator

This position is responsible for reviewing the physician’s daily schedule and obtaining verification of patients’ insurance benefits for their scheduled visits.  They will also obtain authorization for all requested procedures, tests, drugs, etc. The Authorization Coordinator may be asked to perform other duties if necessary & must be knowledgeable of a variety of Insurance Plans and Policies.

Responsibilities/Essential Functions (other duties as assigned):

• Receives PET/CT orders and reviews for compendia compliance, submits for authorization.
• Verify all new, returning, and annual patient eligibility to confirm insurance status and benefits including patient responsibility such as deductible, out of pocket, copay and coinsurance prior to services rendered.
• Utilize online insurance portals, phone communication and other eligibility tools in order to obtain accurate verifications and submit authorization requests based on verified authorization requirements
• Ensures compendia compliance and obtains all required authorization and referral information for patients’ treatments.
• Receives authorization for in-house procedures and document in the patient medical record.  
• Communicates effectively with the Billing and Office Managers as well as billing and clinical staff to ensure appropriate treatment can be provided, claims can be processed accurately and timely payment received.
• Maintains detailed notes in patients’ electronic records.                               
• Reviews schedules daily and ensures appropriate insurance and authorization has been obtained and documented.
• Maintain a high level of confidentiality for patients in accordance to HIPAA standards.
• Ensures patients are contacted prior to appointments to inform them of treatment schedule changes if necessary and when appropriate.
• Become familiar with up-to-date National Comprehensive Cancer Network (NCCN) guidelines.                              
• Effectively completes other duties and projects as assigned.

Experience, Qualifications/Education:

• High School Diploma or equivalent required
• 2-3 years’ experience
• Clinical business training preferred
• Knowledge of computer/telephony support, preferably in a health care environment
• Strong customer service background, preferably in health care environment
• Excellent written and verbal communication skills when interacting with clients, providers and insurance companies
• Competence with computer processing functions and other standard office equipment
• Ability to manage and prioritize multiple tasks
• Ability to calmly and professionally resolve customer issues with diplomacy and tact
• Ability to work independently with minimal supervision
• Strong organizational skills

What is expected of you and others at this level

• Applies acquired job skills and company policies and procedures to complete standard tasks
• Works on routine assignments that require basic problem resolution
• Refers to policies and past practices for guidance
• Receives general direction on standard work; receives detailed instruction on new assignments
• Consults with supervisor or senior peers on complex and unusual problems
   

Anticipated salary range: $16.80-27.95 per hour USD

Benefits: Cardinal Health offers a wide variety of benefits and programs to support health and well-being.

Bonus eligible: No

• Medical, dental and vision coverage
• Paid time off plan
• Health savings account (H