Coordinator, Benefits Eligibility and Authorization

Overview

Benefits Eligibility and Authorization (RCM) contributes to Cardinal Health by managing patient insurance benefits verification, obtaining authorizations for procedures, tests, drugs, and related services, and supporting the coordination between clinical and revenue cycle management teams.

Practice Operations Management oversees the business and administrative operations of a medical practice. This role reviews the physician's daily schedule and verifies patients' insurance benefits for scheduled visits, and may perform other duties as needed. Knowledge of a variety of insurance plans and policies is required.

Responsibilities

• Submit authorizations for all internal and external orders including but not limited to radiation, chemotherapy, PET / CT, urology, and scans
• Follow up within 48 hours on any existing authorizations that are pending approval
• Ensure proper documentation outlining all steps taken to ensure authorizations have been submitted, followed up on and obtained
• Upon approval, enter all authorization information into the billing system and attach confirmation into the patient's account in registration overlay
• Take any action necessary for any denials received by the payor to inform the clinician of changes that may need to happen in order to not delay patient care
• Complete any pre-service appeals to obtain paying approval based on medical necessity
• Communicate effectively with all RCM and clinical staff to ensure appropriate treatment can be provided, claims can be processed accurately and timely payment received
• Maintain a high level of confidentiality for patients in accordance with HIPAA standards
• Coordinate with clinical staff to ensure patients are contacted prior to appointments informing them of any treatment schedule changes if necessary
• Effectively complete other duties and projects as assigned
• Regular attendance and punctuality
• Execute all functions of the role with positivity and team effort by accomplishing related results as needed
• Effectively complete other duties and projects as assigned

Qualifications

Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply.

Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal Opportunity Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity / expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law.

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