Authorization & Eligibility Coordinator - Infusion & Oncology

Boston Medical Center; Cockeysville (MD); On-site; USD 57,079,000 - 85,585,000; Full time

Job summary

GBMC HealthCare in Cockeysville, MD seeks an Insurance Authorization Specialist to manage eligibility, verification and authorization for infusion, oncology and Dance Center patients. You will collaborate with care teams and the billing group to secure timely reimbursements and maintain monthly re-verifications.

The role requires a High School Diploma or GED, about 3 years of authorization experience, and familiarity with ICD-10/CPT coding; Epic experience is preferred.

Qualifications

• 3 years of progressive insurance authorization experience preferred.
• Epic experience desired.
• Knowledge of ICD-10 and CPT coding practices.
• Strong analytical and communication skills.

Responsibilities

• Contacts insurance carriers to verify eligibility, benefits and authorization requirements.
• Obtains insurance authorization for medication dose changes or treatment plans.
• Documents discussions in the Epic referral system.
• Collaborates with infusion staff, Pharmacy, PFS and Dance Center for timely authorizations.
• Reviews medical records and payer criteria to confirm medical necessity.
• Maintains Epic work queues and tracks authorization requirements.

Skills

Authorization processes

Insurance policies

Detail oriented

Telephone skills

Interpersonal skills

Data analysis

EMR knowledge

Microsoft Office

Time management

Education

High School Diploma or GED

Tools

Epic

Microsoft Office

Job description

GBMC HealthCare in Cockeysville, MD seeks an Insurance Authorization Specialist to manage eligibility, verification and authorization for infusion, oncology and Dance Center patients. You will collaborate with care teams and the billing group to secure timely reimbursements and maintain monthly re-verifications.

The role requires a High School Diploma or GED, about 3 years of authorization experience, and familiarity with ICD-10/CPT coding; Epic experience is preferred.