Lead Oncology Authorization Coordinator

This is a fully remote position, open to applicants in Florida.

📋 Description

• Act as a mentor for newly hired staff.

• Request, track, acquire, and confirm authorizations, referrals, and notifications with the appropriate CPT and ICD-10 codes within specified timeframes for Oncology Radiation/Infusion.

• Operate in a call center-like setting while achieving personal quality metrics.

• Coordinate patient movement and ensure prompt processing.

• Stay informed and apply practices relevant to the department, physician practice, and hospital to address patient inquiries or issues.

• Serve as a resource for authorizations and assume a leadership role when a Manager/Supervisor is not present.

• Keep updated on insurance requirements, BHSF pricing, financial assistance options, and BHSF Revenue Cycle operations.

• Assist in supporting go-lives and departmental initiatives.

• Engage in departmental committees and champion opportunities.

• Provide professional, caring, and friendly assistance to patients of all ages, their families, employees, physicians, and community members.

⛳️ Requirements

• High School diploma, certification, GED, training, or experience.

• Minimum required experience: 4 years.

• For internal staff: At least 4 years of experience in validating and obtaining authorizations.

• Must meet or exceed all Individual Performance Standards for the most recent 12 months.

• Surpass departmental KPIs.

• Support colleagues and mentor new hires.

• Cross-trained in various areas, product lines, and practices to cover all staff roles as necessary.

• For external candidates: An AA degree is preferred, along with 4 years of experience in validating and obtaining authorizations or 5 years of experience in lieu of a degree.

• Completion of Prior Authorization On-Demand Webinars within 3 months of hire, with yearly updates required.

• Successfully complete the Patient Access training course.

• Ability to thrive in a high-volume, fast-paced work environment and perform basic mathematical calculations.

• Detail-oriented, organized, a team player, compassionate, with excellent customer service and interpersonal communication skills.

• Desired: Knowledge of authorization guidelines specific to Oncology Radiation/Infusion.

• Leadership experience is preferred.

• Familiarity with healthcare regulatory guidelines, including HIPAA, AHCA, EMTALA, Medicare coverage structure, and medical necessity compliance guidelines.

• Working knowledge of insurance contracts and authorization/pre-certification processes.

• Proficiency in Microsoft Office products and EMR applications.

• Understanding of medical terminology.

• Bilingual in English and Spanish/Creole is preferred.

🏝️ Benefits

• Opportunities for career growth and development, with clear pathways and ongoing support.

• Comprehensive health and wellness resources.

• A wellness program designed to help employees eliminate their medical plan deductible.

• Tuition reimbursement.

• And much more.