Specialty Authorization Coordinator Infusion and Oncology - Remote in VirginiaA

Position: Specialty Authorization Coordinator for Infusion and Oncology - Remote in VirginiaA
** City/State
** Norfolk, VA
** Work Shift
** First (Days)
** Overview:**#
*** Sentara Patient Accounting is hiring for a Specialty Authorization Coordinator for Infusion and Oncology
- Remote in Virginia!
***** Position Status:
Full-time, permanent (40 hours/week)
**** Standard

Working Hours:

8 AM to 5 PM EST, M-F**##
*
* Location:

Remote in Virginia
**** Overview:
** The Specialty Authorization Coordinator is responsible for securing prior authorizations for patient services that are complex in nature, specific to radiation oncology and series infusion patients. This role requires drug calculations and more significant research and review of clinical documentation while ensuring compliance with payer rules and policies. The role of the Specialty Authorization Coordinator involves collaborating with medical practice staff, providers and patients to facilitate the authorization, retro-authorization, and peer to peer process utilizing payer portals and automation tools effectively.

The Specialty Authorization Coordinator maintains up-to-date knowledge of insurance plans and regulations and is adept in identifying patient insurance and benefits to streamline the authorization workflow.  
*
* Key Responsibilities:

** Obtain and Verify Authorizations:
Request and secure prior authorizations for procedures, diagnostic testing, hospital admissions, and specialty services according to payer requirements.

Insurance Verification:
Confirm patient insurance eligibility, benefits, and coverage details to ensure services are authorized appropriately.

Documentation:
Accurately record authorization numbers, payer requirements, and status updates in the electronic health record (EHR) or billing system.

Communication:
Serve as a liaison between providers, patients, and insurance companies to clarify requirements and resolve authorization issues.

Follow-Up:
Track pending authorizations, monitor turnaround times, and escalate delays to prevent service denials or scheduling disruptions.

Denial Prevention and Revenue Cycle Support:
Review payer policies and authorization guidelines to reduce authorization-related claim denials. Partner with revenue integrity teams to resolve authorization-related denials.

Collaboration:

Work closely with clinical staff, schedulers, and billing teams to ensure all necessary approvals are obtained prior to service delivery.

Confidentiality & Compliance:
Adhere to HIPAA and organizational policies while handling sensitive patient and insurance information.
** Education
* ** HS - High School Grad or Equivalent
** Certification/Licensure
*** None required
** Experience
* ** Health Insurance Authorizations- 3 years
** REQUIRED
* ** Prior experience in procedures/treatment plans/imaging preferred
* Medical terminology and ICD-10 knowledge preferred
* Strong attention to detail, follow up, organizational skills, and clear communication are essential to success in this role.
** Sentara Health**, an integrated, not-for-profit health care delivery system, celebrates more than 135 years in pursuit of its mission - "we improve health every day."Sentara is one of the largest health systems in the U.S. Mid-Atlantic and Southeast, and among the top 20 largest not-for-profit integrated health systems in the country, with 34,000 employees, 12 hospitals in Virginia and Northeastern North Carolina, including 10 hospitals with the prestigious Magnet recognition, and the Sentara Health Plans division which serves more than 1 million members in Virginia and Florida.

Sentara is recognized nationally for clinical quality and safety and is strategically focused on innovation and creating an extraordinary health care experience for our patients and members. Sentara was named a Health Quality Innovator of the Year (2024), was recognized by Forbes as "America’s Best-In-State Employer” (2024), "Best Employer for Veterans" (2022, 2023), and "Best Employer for Women" (2020), and named to IBM Watson Health's "Top 15 Health Systems" (2021, 2018).
** Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a…