Remote-Eligible Managed Care Navigator

aoncology; Honolulu (HI); On-site; USD 25,000 - 35,000; Full time

Job summary

Hawaii Cancer Care is seeking a Managed Care Coordinator to join our team. This role acts as the liaison between the Financial Counselor and the Utilization Management and Intake teams, coordinating managed care review of benefits, authorizations, referrals and streamlining communications for patient services.

You will verify insurance benefits in EMR and billing systems, assist with pre-certification and prior authorization, and ensure services meet coverage requirements.

Qualifications

• Education: High school diploma or GED required; further education a plus.
• Healthcare experience preferred in a clinical or business office setting; strong insurance/medical terminology knowledge.
• Experience verifying pre-certification and prior authorization with medical insurance.

Responsibilities

• Coordinate pre-certification and prior authorization with insurance companies and care teams.
• Review patient treatment plans and verify active insurance coverage and applicable benefits.
• Communicate with Financial Counselor, Intake, UM teams and providers to complete managed care tasks.
• Ensure accurate documentation in EMR and billing systems and handle billing compliance.

Skills

Communication skills

Analytical thinking

Time management

Organization

Interpersonal effectiveness

Self-management

Education

High School Diploma or GED

Tools

MS Office

Excel

PowerPoint

Outlook

Job description

Hawaii Cancer Care is seeking a Managed Care Coordinator to join our team. This role acts as the liaison between the Financial Counselor and the Utilization Management and Intake teams, coordinating managed care review of benefits, authorizations, referrals and streamlining communications for patient services.

You will verify insurance benefits in EMR and billing systems, assist with pre-certification and prior authorization, and ensure services meet coverage requirements.