Authorization Coordinator: Oncology & Billing Support

Sutter Health; Oakland (CA); On-site; USD 53,000 - 74,000; Full time

Benefits offered by this job

Benefits

Job summary

Sutter Health is seeking an Authorization Coordinator for the SEBMF-East Bay Medical Foundation to manage insurance verification, eligibility, and prior authorizations for oncology services. You will collaborate with clinicians and administrative staff to ensure timely approvals and accurate coding, while guiding patients through cost considerations and financial assistance options.

The role emphasizes accurate data entry in EPIC, adherence to payer guidelines, and coordination with Revenue

Qualifications

• HS Diploma or GED required.
• 2 years of recent relevant experience.
• Experience with insurance verification and prior authorizations is preferred.

Responsibilities

• Verify insurance and eligibility information is accurate.
• Obtain initial and subsequent PPO authorizations.
• Initiate referrals to managed care for HMO authorizations.
• Enter authorizations into EPIC with correct codes.
• Communicate authorization issues with supervisor, nurses and staff.
• Provide financial counseling for patients regarding insurance benefits and costs.
• Review chemotherapy-related charges and ensure billing codes are correct.
• Assist patients with programs and waivers as needed.

Skills

Chemotherapy meds

Medical terminology

Verbal/written comm

Math aptitude

Organizational skills

Teamwork

Data entry

Education

HS Diploma

Tools

EPIC system

Job description

Sutter Health is seeking an Authorization Coordinator for the SEBMF-East Bay Medical Foundation to manage insurance verification, eligibility, and prior authorizations for oncology services. You will collaborate with clinicians and administrative staff to ensure timely approvals and accurate coding, while guiding patients through cost considerations and financial assistance options.

The role emphasizes accurate data entry in EPIC, adherence to payer guidelines, and coordination with Revenue