Oncology Infusion Authorization Counselor

AdventHealth; Denver (CO); On-site; USD 29,000 - 47,000; Full time

Benefits offered by this job

Benefits from Day One

Paid Time Off from Day One

403-B Retirement Plan

4 Weeks 100% Paid Parental Leave

Career Development

Whole Person Well-being Resources

Mental Health Resources and Support

Pet Benefits

Job summary

AdventHealth in Denver seeks a detail‑oriented specialist to manage medication-related prior authorizations. You will verify insurance requirements, obtain clinical data, and submit documentation within Epic EMR, ensuring timely approvals.

The role requires 1+ year healthcare experience, ICD-10/CPT knowledge, and strong customer service. Hybrid or on‑site options may apply; caseload supports patient cost estimates and billing coordination.

Qualifications

• Medical terminology required.
• Insurance eligibility and verification experience required.
• Minimum of 1 year health care experience required.
• Knowledge of ICD-10 and CPT coding required.
• Good customer service skills required.
• Computer skills and willingness to use technology required.
• Epic knowledge preferred.

Responsibilities

• Verify prior authorization requirements based on patient insurance.
• Obtain clinical information from patient chart for authorizations.
• Submit documentation and track authorization status.
• Document authorization details in Epic EMR.
• Coordinate with providers, nursing, pharmacy, and front desk on authorization status.
• Communicate patient and clinic billing questions to Revenue Management.

Skills

Medical terminology

Insurance eligibility

Healthcare experience

ICD-10/CPT coding

Customer service

Computer skills

Epic knowledge

Education

Associate

Bachelor's

High School Grad or Equiv

Job description

Our Promise To You

Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that

Our Promise To You

Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

All the benefits and perks you need for you and your family:

• Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance
• Paid Time Off from Day One
• 403-B Retirement Plan
• 4 Weeks 100% Paid Parental Leave
• Career Development
• Whole Person Well-being Resources
• Mental Health Resources and Support
• Pet Benefits

Schedule

Full time

Shift

Day (United States of America)

Address

2525 S DOWNING ST

City

DENVER

State

Colorado

Postal Code

80210

Job Description

Monitors work queues for unauthorized and expiring medication-based referrals. Verifies prior authorization requirements based on the patient's specific insurance provider. Obtains clinical and treatment/therapy information from the patient's chart. Submits clinical documentation with prior authorization requests and tracks authorization status. Schedules peer-to-peer or appeal as needed. Documents authorization information in Epic EMR. Communicates insurance and facility preferred products and authorization status with providers, nursing team, pharmacy team, front desk, and MA team. Verifies insurance coverage, benefits, and network status. Provides patient cost estimates based on specific treatment protocol and patient benefits. Monitors the schedule for self-pay patients and prepares estimates. Communicates the amount due at the time of service with the patient and patient service representatives. Coordinates patient care with third-party copay and free drug assistance vendors. Addresses patient and clinic billing questions and concerns, routing patient concerns to Revenue Management and Billing departments. Maintains good working knowledge of chemotherapy authorization requirements for all payers, state and federal regulatory guidelines for coverage and authorizations. Other duties as assigned.

Knowledge, Skills, And Abilities

• Medical terminology [Required]
• Insurance eligibility and verification [Required]
• Minimum of 1 year health care experience [Required]
• Knowledge of ICD 10 and CPT coding [Required]
• Good customer service skills. [Required]
• Computer skills and willingness to use technology. [Required]
• Understanding of various hematologic and oncologic conditions and malignancies. [Preferred]
• Understanding of treatments used to treat various oncologic and hematologic conditions. [Preferred]
• Knowledge of registration and billing [Preferred]
• Epic knowledge. [Preferred]

Education

• Associate [Preferred]
• Bachelor's [Preferred]
• High School Grad or Equiv [Required]

Field Of Study

• N/A

Work Experience

• Eligibility, billing, coding, registration experience [Preferred]
• Health care or pharmaceutical experience [Preferred]
• Previous HBA experience [Preferred]

Additional Information

• N/A

Licenses And Certifications

• N/A

Physical Requirements:

Physical Requirements - https://tinyurl.com/23km2677

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

Pay Range

$21.40 - $34.24