Benefits Eligibility & Authorization Lead – Oncology

Cardinal Health, Inc.; Northern (KY); Hybrid; USD 32,000 - 40,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

Paid time off plan

401k savings plan

Flexibility with work arrangements

Job summary

Navista, in partnership with Cardinal Health, seeks a Lead Coordinator for Benefits Eligibility and Authorization to oversee daily operations of the Eligibility and Authorization team. You will verify insurance coverage, obtain authorizations, and guide staff through complex scenarios across Oncology, Radiation, and Imaging services.

The role blends leadership with hands-on work, requiring strong problem-solving, training, and performance reporting.

Qualifications

• 4-5 years of experience, preferred.
• Minimum four years of experience in a medical business office.
• Knowledge of medical terminology.
• Familiar with Urology, Chemotherapy, PET, and Radiation Billing.
• Experience with computerized billing software and interpreting EOBs.
• Working knowledge of ICD-10, CPT, HCPCS, and CPT coding.
• Knowledge of computer/telephony support, preferably in a healthcare environment.
• Strong customer service background, preferably in a healthcare environment.
• Competence with computer processing functions and other standard office equipment.
• Prior experience in Microsoft Office Suite.
• 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.

Responsibilities

• Provide daily workflow support and problem-solving assistance utilizing the SOPs and reference documents for consistency and accuracy in response to Eligibility and Authorization coordinators through Teams chats, emails, and direct communication via teams calls.
• Respond to team member questions regarding policies, procedures, complex cases, and system-related issues in a timely and thorough manner
• Train and onboard new Eligibility and Authorization coordinators, ensuring they understand department processes, systems, and performance expectations
• Monitor and review team performance and productivity metrics on a regular basis, identifying trends, opportunities for improvement, and coaching needs
• Act as an escalation point for complex eligibility and authorization delays that require advanced problem-solving, ensuring prompt resolution
• Coordinate and communicate information required or requested by other internal teams or site stakeholders within 24 hours
• Oversee and provide expert guidance on prior authorizations for Medical Oncology, Radiation, Imaging therapies, and other high-risk denial medications, ensuring robust clinical documentation, payer-criteria alignment, proactive appeals management, and minimized treatment delays for vulnerable patient populations
• Maintain up-to-date knowledge of payer-specific requirements, including Medicaid, Medicare Advantage plans and various commercial insurance plans as well as notify Benefits Eligibility and Authorization Management of any issues that have potential for a negative outcome for the organization.
• Demonstrates exceptional analytical and problem-solving abilities with a strong focus on accuracy and precision.
• Communicate effectively with all Revenue Cycle Management staff and clinical staff to ensure appropriate treatment can be provided, claims can be processed accurately and timely payment received.
• Maintain excellent customer service and kindness with all patients and staff.
• Maintain a high level of confidentiality for patients in accordance with HIPAA standards.
• Regular attendance and punctuality.
• Execute all functions of the role with positivity and team effort by accomplishing related results as needed.
• Effectively completes other duties and projects assigned.

Skills

Medical terminology

Customer service

Microsoft Office

Organizational skills

Task prioritization

Tools

Billing software

EOB interpretation

Job description

Navista, in partnership with Cardinal Health, seeks a Lead Coordinator for Benefits Eligibility and Authorization to oversee daily operations of the Eligibility and Authorization team. You will verify insurance coverage, obtain authorizations, and guide staff through complex scenarios across Oncology, Radiation, and Imaging services.

The role blends leadership with hands-on work, requiring strong problem-solving, training, and performance reporting.