Oncology Authorization Navigator

About the role

The Oncology Authorization Navigator coordinates and facilitates insurance verification, prior authorizations, and financial navigation processes for oncology patients at the Cancer Care Institute locations in Egg Harbor Township and Cape May Court House. This role supports both Radiation Oncology and Medical Oncology services, ensuring accurate and timely completion of access and billing functions critical to patient care and revenue cycle operations.

Responsibilities

• Coordinate and facilitate insurance verification, prior authorizations, and financial navigation processes for oncology patients, supporting both Radiation and Medical Oncology services.
• Oversee pre-certifications, authorizations, and financial clearance activities, ensuring accurate and timely completion for patient care and revenue cycle operations.
• Work closely with Financial Navigators to provide seamless financial navigation, particularly for patients with complex treatment plans or financial challenges.
• Possess comprehensive knowledge of all insurance payers (commercial, Medicare, Medicaid, and government programs) and ensure accurate insurance clearance and coordination of benefits across multiple payers.
• Verify insurance coverage and eligibility prior to service to prevent claim denials or delays.
• Ensure the accurate assignment of ICD-10 and CPT codes for oncology services, including treatments, imaging, laboratory studies, medications, procedures, and supportive care.
• Facilitate physician-to-physician peer reviews for cases requiring additional clinical documentation or justification.
• Reconcile charge data and ensure timely processing of oncology-related accounts.
• Act as a liaison between the oncology team, Patient Access, Financial Navigators, and other departments to promote continuity of care and optimize revenue cycle outcomes.
• Aid in insurance appeals and resolve denials to ensure timely reimbursement and accurate claims processing.
• Ensure patient accounts are complete, accurate, and ready for billing, coordinating communication between clinical and administrative staff to avoid treatment delays.
• Attend all required training sessions and in-services to maintain proficiency in job duties and departmental procedures.
• Perform additional duties related to patient financial support services or other departmental areas as needed.

Qualifications

To succeed in this role, candidates should have a strong background in healthcare administration, insurance processing, and patient advocacy. A bachelor's degree in a relevant field is preferred, along with experience in oncology or healthcare finance. Proficiency in Microsoft Office and familiarity with electronic health records (EHR) systems is essential. Excellent communication and problem-solving skills are required, as is the ability to manage multiple tasks simultaneously and prioritize effectively.

Skills

• Comprehensive knowledge of insurance payers (commercial, Medicare, Medicaid, and government programs)
• Strong organizational and time management skills
• Excellent communication and interpersonal skills
• Ability to work independently and as part of a team
• Proficiency in Microsoft Office and EHR systems

Benefits

Total Rewards at AtlantiCare offers a competitive benefits package including:

• Generous Paid Time Off (PTO)
• Medical, Prescription Drug, Dental & Vision Insurance
• Retirement Plans with employer contributions
• Short-Term & Long-Term Disability Coverage
• Life & Accidental Death & Dismemberment Insurance
• Tuition Reimbursement
• Flexible Spending Accounts (FSAs) for healthcare and dependent care
• Wellness Programs
• Voluntary Benefits, including Pet Insurance

Pay

Competitive compensation and benefits package.

Schedule

Full-time position.