Lead Coordinator, Benefits Eligibility and Prior Authorization

Lead Coordinator, Benefits Eligibility and Authorization

About Navista

We believe in the power of community oncology to support patients through their cancer journeys. As an oncology practice alliance comprised of more than 40 sites, Navista provides the support community practices need to fuel their growth—while maintaining their independence.

What Revenue Cycle Management (RCM) contributes to Cardinal Health

Practice Operations Management oversees the business and administrative operations of medical practices.

The Revenue Cycle Management manages a team focused on a series of clinical and administrative processes that healthcare providers utilize to capture, bill, and collect patient service revenue. The revenue cycle shadows the entire patient care journey and begins with patient appointment scheduling and ends when the patient’s account balance is zero.

Job Purpose

The Team Lead for Benefits Eligibility and Authorization is responsible for overseeing the daily operations of the Eligibility and Authorization team while maintaining hands-on involvement in verifying and maintaining insurance coverage and obtaining authorization across all patient accounts for all lines of business. This role combines individual contributor responsibilities with leadership duties, including problem-solving, staff support, training, as well as presenting performance trends to the supervisor for performance management. The Team Lead guides team members through complex eligibility scenarios and provides expert guidance on prior authorizations for Medical Oncology, Radiation, and other Imaging therapies. This position communicates with patients and other departments regarding patient coverage, eligibility, and authorizations.

Responsibilities

• Provide daily workflow support and problem-solving assistance utilizing the SOP’s 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.

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.

What is expected of you and others at this level

• Applies acquired job skills and company policies and procedures to complete standard tasks.
• Works on routine assignments that require basic problem resolution.
• Refers to policies and past practices for guidance.
• Receives general direction on standard work; receives detailed instruction on new assignments.
• Consults with supervisor or senior peers on complex and unusual problems.

Anticipated hourly range: $22.60 - $29.25

Bonus eligible: No

Benefits: Cardinal Health offers a wide variety of benefits and programs to support health and well-being.

• Medical, dental and vision coverage
• Paid time off plan
• Health savings account (HSA)
• 401k savings plan
• Access to wages before pay day with myFlexPay
• Flexible spending accounts (FSAs)
• Short- and long-term disability coverage
• Work-Life resources
• Paid parental leave
• Healthy lifestyle programs

Application window anticipated to close: 11/16/2026 *if interested in opportunity, please submit application as soon as possible.

The hourly range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate’s geographical location, relevant education, experience and skills and an evaluation of internal pay equity.

Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply.

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Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply.

Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law.

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Originally posted on Himalayas