Authorization Specialist

Carolina Oncology Specialists has been providing compassionate, patient-centered care since 1983, delivering high-quality oncology and hematology services tailored to each individual's needs. Patients benefit from the convenience of receiving chemotherapy treatments in our clinics, along with expert diagnosis, treatment, and management of a wide range of blood disorders.Why Join Us?We are seeking talented, compassionate, and highly motivated individuals who are passionate about making a difference. At Carolina Oncology Specialists, you'll have the opportunity to support the meaningful work of community oncology while helping provide exceptional care and hope to the patients and families we serve. Join a team dedicated to clinical excellence, collaboration, and improving lives every day.Job Description:Job Title: Authorization SpecialistDepartment: Revenue Cycle ManagementLocation: Carolina Oncology Specialists-RemoteReports To: Authorization ManagerPosition SummaryThe Authorization Specialist is responsible for obtaining and verifying prior authorizations for oncology services, including chemotherapy, radiation therapy, imaging, and supportive care. This role ensures timely approvals, minimizes treatment delays, and maintains compliance with payer requirements while supporting high-quality patient care.Key ResponsibilitiesObtain prior authorizations for oncology treatments, procedures, medications, and diagnostic services in a timely mannerReview provider orders, treatment plans, and clinical documentation to ensure medical necessity and completeness prior to submissionCommunicate with insurance companies, payers, and specialty pharmacies to secure approvals and document authorization detailsTrack authorization status and follow up to prevent delays in patient careCollaborate with physicians, nurses, and clinical staff to resolve authorization issues or denialsSubmit appeals and provide supporting documentation for denied services when appropriateMaintain accurate and detailed records in the electronic health record (EHR) and/or practice management systemVerify insurance benefits, coverage limitations, and patient eligibility as neededEnsure compliance with payer guidelines, regulatory requirements, and organizational policiesIdentify trends in denials or delays and escalate issues to leadership for process improvementQualificationsRequired:High school diploma or equivalentMinimum of 2–3 years of experience in healthcare prior authorizations, medical billing, or revenue cycle operationsKnowledge of insurance plans, including Medicare, Medicaid, and commercial payersExperience working with EHR and practice management systemsStrong attention to detail and organizational skillsPreferred:Experience in oncology or specialty practiceCertification in medical billing/coding (e.g., CPC, CPAR, or similar)Familiarity with chemotherapy regimens and oncology-specific authorization processesKey CompetenciesStrong communication and interpersonal skillsAbility to manage multiple priorities in a fast-paced environmentProblem-solving and critical thinkingHigh level of accuracy and attention to detailCustomer service orientation with a patient-centered approachWorking ConditionsPrimarily office-based or remote work environmentFrequent use of computers, phones, and healthcare systemsMay require extended periods of sitting and screen timePhysical RequirementsAbility to sit for extended periodsAbility to use standard office equipment, including computers and telephones #J-18808-Ljbffr OneOncology, LLC