What Revenue Cycle Management (RCM) contributes to Cardinal Health Practice Operations Management oversees the business and administrative operations of a medical practice. 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 Authorization Manager is responsible to develop and implement consistent guidelines and staff development for verifying and determining patients' eligibility for insurance benefits and securing any necessary prior authorizations for treatment for all medically necessary services and ensuring access for all patients.
Essential Functions:
Develop, document, and implement best practice workflows for the daily operations of all benefit eligibility coordinator and authorization coordinator staff and Team Leads.
Ensure curriculum and technology is well understood by staff and utilized appropriately.
Responsible for VOB and Authorization denials management by root cause analysis and coaching
Manage all preservice denials and appeals
Monitors, tracks, and analyzes staff productivity
Direct all STAT or pending orders waiting on authorizations
Maintain reporting to ensure there are minimal claims holding due to authorization needs.
Intervenes in crisis situations - quickly and independently discerning interventions required - using sound analysis, professional judgment, ethical practice, and common sense.
Work closely with providers, patient navigators, front office staff and clinical staff to ensure smooth patient access.
Lead monthly check in meeting with all staff members both individually and in group setting to review performance and establish goals moving forward.
Completes all performance evaluations, delivers coaching and disciplinary action and performance improvement plans.
Work closely with training team for new hire onboarding.
Create training policies for VOB and authorization training workflows
Deliver monthly KPI?s on time for prior month.
Assist with organization initiatives to support integrations for new provider partners
Manage and approve all team member timecards, PTO, etc.
Regular attendance and punctuality.
Performs other duties as assigned."
Qualifications and Education Requirements
4 years of general management experience, preferred
3 or more years? experience in patient access management specifically responsible for authorizations, verification of benefits, denials and/or appeals.
Bachelor's degree in related field, or equivalent work experience, preferred
Ability to work a flexible schedule as necessary.
Working knowledge of medical terminology as well as ICD-9 and CPT codes.
Strong written/verbal communication skills.
Strong competency of Microsoft Word, Power point and Excel
Manages department operations and supervises professional employees, front line supervisors and/or business support staff
Participates in the development of policies and procedures to achieve specific goals
Ensures employees operate within guidelines
Decisions have a short-term impact on work processes, outcomes and customers
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: 05/05/2025 *if interested in opportunity, please submit application as soon as possible.
The salary 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.
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.
Headquartered in Dublin, Ohio, Cardinal Health, Inc. (NYSE: CAH) is a distributor of pharmaceuticals, a global manufacturer and distributor of medical and laboratory products, and a provider of performance and data solutions for healthcare facilities.We are a crucial link between the clinical and operational sides of healthcare, delivering end-to-end solutions and data-driving insights that advance healthcare and improve lives every day. With deep partnerships, diverse perspectives and innovative digital solutions, we build connections across the continuum of care. With more than 50 years of experience, we seize the opportunity to address healthcare's most complicated challenges – now, and in the future.As a global, growing company, we’re able to offer rewarding careers that let you make a positive impact on our customers and communities.