Authorization and Benefits Coordinator

About Navista At Navista, we are passionate about empowering patients on their cancer journeys by leveraging the strength of community oncology. Our innovative practice alliance connects over 100 providers across 50 sites, ensuring vital support for community practices while maintaining their independence. Role in Revenue Cycle Management (RCM) Our Practice Operations Management plays a crucial role in managing the financial and administrative aspects of medical practices. Job Purpose: The Revenue Cycle Management team is essential for overseeing the processes that healthcare providers utilize to secure, bill, and collect revenue from patient services. This journey begins with scheduling patient appointments and extends until every account balance is cleared. As the Authorization and Benefits Coordinator, you will validate patients' insurance benefits prior to their visits by reviewing the physician's schedule. Additionally, you will secure prior authorization for necessary procedures, tests, and medications. This role also requires flexibility to take on related tasks and a solid understanding of various insurance plans and procedures. Responsibilities: Confirm eligibility and insurance benefits for new, returning, and annual patients prior to service, including assessing patient financial responsibilities such as deductibles and co-pays. Engage with patients, front-end staff, physicians, and payers to gather updated insurance and clinical information. Obtain prior authorizations for all essential internal and external orders, including radiation therapy, chemotherapy, and imaging scans. Follow up on pending authorizations within 48 hours to ensure timely approvals. Document all actions taken to secure authorizations thoroughly. Once authorizations are granted, enter the information into the billing system and attach confirmation to the electronic medical record (EMR). Address any payer denials promptly and communicate necessary changes to clinicians to prevent delays in patient care. Complete pre-service appeals to obtain approvals based on medical necessity. Collaborate effectively with RCM and clinical teams to ensure appropriate treatments, accurate claim submissions, and timely payments. Maintain patient confidentiality in compliance with HIPAA standards. Utilize knowledge of CPT and ICD-10 coding to accurately document procedures and diagnoses. Work with clinical staff to ensure patients are properly contracted before appointments while keeping them informed of any treatment schedule changes. Manage additional assigned duties and projects efficiently. Stay informed on the latest insurance policies, managed care guidelines, and healthcare regulations affecting authorization processes. Exhibit regular attendance and punctuality. Approach all tasks with a positive attitude and a spirit of teamwork. Qualifications: High School Diploma or equivalent is preferred. 2-3 years of experience in prior authorizations is preferred. Familiarity with payer websites and authorization protocols is required. A strong background in customer service, particularly in a healthcare setting. Excellent verbal communication skills. Proficiency in computer processing functions and standard office equipment. Able to handle multiple priorities in a fast-paced environment. Self-motivated and able to work with minimal supervision. Strong organizational skills. Knowledge of medical terminology. Experience with billing related to urology, chemotherapy, and radiation is preferred. Familiarity with computerized billing software and understanding of Explanation of Benefits (EOBs). Working knowledge of ICD-9/ICD-10, CPT, and HCPCS coding. Experience with GE Centricity is a plus; oncology billing knowledge is advantageous. Understanding of managed care contracts and fee schedules, including Medicare and Medicaid. What is expected at this level: Utilize learned skills and adhere to company policies to accomplish standard tasks. Handle routine assignments requiring basic problem-solving skills. Refer to established policies and past practices for guidance. Receive general direction for standard work; detailed instructions for new tasks. Consult with supervisors or knowledgeable peers on more complex issues. Anticipated hourly range: $21.00 - $26.45 Bonus eligible: No Benefits: We offer a comprehensive array of benefits and programs tailored to support your health and well-being. 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 Application window anticipated to close: 2/15/16. We encourage you to apply promptly if you are interested in this opportunity. The listed hourly range is an estimate. Compensation at Cardinal Health is determined by factors including geographical location, experience, skills, education, and internal pay equity assessments. We welcome applications from individuals re-entering the workforce, people with disabilities, those without a college degree, and veterans. Cardinal Health is dedicated to fostering an inclusive workplace that respects diverse perspectives and backgrounds. We celebrate our differences and strive to create better solutions for our customers, allowing all employees to be their authentic selves.

Created: 2026-03-11