Prior Authorization Coordinator

About the position

The Authorization Coordinator position at Cardinal Health is integral to the Revenue Cycle Management (RCM) team, which oversees the clinical and administrative processes that healthcare providers use to capture, bill, and collect patient service revenue. This role is responsible for ensuring that patients' insurance benefits are verified and that necessary authorizations for procedures, tests, and medications are obtained. The position requires a thorough understanding of various insurance plans and policies, as well as compliance with healthcare regulations such as HIPAA.

Responsibilities

• Review physician's daily schedule and verify patients' insurance benefits for scheduled visits.
• Obtain authorization for all requested procedures, tests, drugs, etc.
• Receive chemotherapy orders, review for compendia compliance, and submit for authorization.
• Ensure compendia compliance and obtain all required authorization and referral information for patients' treatments.
• Document authorization for in-house and outpatient procedures in the patient medical record.
• Communicate effectively with Billing and Office Managers, as well as billing and clinical staff, to ensure appropriate treatment and timely payment.
• Maintain detailed notes in patients' electronic records.
• Review schedules daily to ensure appropriate insurance and authorization has been obtained and documented.
• Contact patients prior to appointments to inform them of treatment schedule changes when necessary.
• Familiarize with up-to-date NCCN guidelines.
• Complete other duties and projects as assigned.

Requirements

• High School Diploma or equivalent required
• 2-3 years' experience in a relevant field
• Clinical business training preferred
• Knowledge of computer/telephony support, preferably in a healthcare environment
• Strong customer service background, preferably in a healthcare environment
• Excellent verbal communication skills
• Competence with computer processing functions and 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

Benefits

• Medical, dental and vision coverage
• Paid time off plan
• Health savings account (HSA)
• 401k savings plan
• Access to wages before payday with myFlexPay
• Flexible spending accounts (FSAs)
• Short- and long-term disability coverage
• Work-Life resources
• Paid parental leave
• Healthy lifestyle programs