Benefits and Authorization Coordinator

High School Diploma or equivalent required
2-3 years’ experience
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

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.