Deskripsi Pekerjaan
Informasi lengkap tentang posisi dan persyaratan
Ringkasan Yukerja
Lowongan Authorization Specialist di COS Carolina Oncology Specialists, P.A. kami kurasi dari Himalayas (kategori Kesehatan). Posisi ini ditandai sebagai remote — pastikan timezone dan syarat lokasi kandidat di deskripsi resmi. Yukerja.com bukan pemberi kerja — lamaran diproses di situs sumber resmi.
Carolina Oncology Specialists has been caring for patients in Catawba County since 1983, offering patients high quality, personalized healthcare close to their own home so patients and caregivers don’t have to travel far for excellent care. Our patients experience the convenience of in-clinic chemotherapy treatments, as well as the treatment and management of blood disorders.
Why Join Us? We are looking for talented and highly-motivated individuals who demonstrate a natural desire to support the meaningful work of community oncologists and the patients we serve.
Job Description:
Job Title:Authorization Specialist
Department:Revenue Cycle Management
Location:Carolina Oncology Specialists TBD
Reports To:Precertification/Authorization Manager
Position Summary
The Authorization Specialistis responsible forobtaining and verifying prior authorizations for oncology services, includingtreatmentanddiagnosticimaging.This role ensurestimelyapprovals, minimizes treatment delays, andmaintainscompliance with payer requirements while supporting high-quality patient care.
Key Responsibilities
Obtain prior authorizations for oncology treatments, and diagnosticimagingin a timely manner
Review provider orders, treatment plans, and clinical documentation to ensure medical necessity and completeness prior to submission
Communicate withpayersorthird-partyadministratorsto secure approvals and document authorization details
Track authorization status and follow up to prevent delays in patient care
Collaborate with physicians, nurses, and clinical staff to resolve authorization issues or denials
Submit appeals and provide supporting documentation for denied services when appropriate
Coordinate peer to peer reviews when appropriate
Maintainaccurateand detailed records in the electronic health record (EHR) and/or practice management system
Verify insurance benefits, coverage limitations, and patient eligibility as needed
Coordinate drug changes,according to payer restrictions,withappropriate staff
Ensure compliance with payer guidelines,to include review of preferred drug lists and step therapy requirements,regulatory requirements, and organizational policies
Identifytrends in denials or delays and escalate issues to leadership for process improvement
Access financial appropriateness of in-house treatment
Qualifications
Required:
High school diploma or equivalent
Minimum of 2–3 years of experience in healthcare prior authorizations, medical billing, or revenue cycle operations
Knowledge of insurance plans, including Medicare, Medicaid, and commercial payers
Experience working with EHR and practice management systems
Strong attention to detail and organizational skills
Preferred:
Experience in oncology or specialty practice
Certification in medical billing/coding (e.g., CPC, CPAR, or similar)
Familiarity with chemotherapy regimens and oncology-specific authorization processes
Key Competencies
Strong communicationand interpersonal skills
Ability to manage multiple priorities in a fast-paced environment
Problem-solving and critical thinking
High levelof accuracy and attention to detail
Customer service orientation with a patient-centered approach
Working Conditions
Primarily office-based or remote work environment
Frequent use of computers, phones, and healthcare systems
May require extended periods of sitting and screen time
Physical Requirements
Ability to sit for extended periods
Ability to use standard office equipment, including computers and telephones
Originally posted on Himalayas