Authorization Specialist - Oncology and Hematology
$18.09 - $24.24 per hourFrederick Health Medical Group, LLC
Authorization Specialist - Oncology and Hematology Job Category : Admin/Clerical Requisition Number : AUTHO012548 Posted : August 24, 2026 Full-Time Locations Showing 1 location 1562 Opossumtown Pike Frederick, MD 21702, USA Description Frederick Health is seeking a full-time Authorization Specialist for our Oncology and Hematology office. Monday to Friday 8am - 4:30pm or 8:30am-5pm Job Summary Supports, and is responsible for incorporating into job performance, the Frederick Health (FH) mission, vision, core values and customer service philosophy and adheres to the FH Compliance Program, including following all regulatory requirements and the FH Standards of Behavior. The Oncology and Hematology Authorization Specialist is responsible for monitoring, obtaining, pre-authorizing, generating appeals, coordinate peer to peer review for phlebotomy, IV infusion and oral medications as well as radiology exams and genetic testing. Example of Essential Functions: Will monitor and obtain all pre-authorizations for phlebotomy, IV Infusion and oral medication, radiology and genetic testing. Monitors physician orders to ensure they meet NCCN guidelines. Initiates contact with the patient to obtain and review necessary financial documents for qualifying drug assistance programs. Maintains strict confidentiality in all dealings related to patients, physicians, accounts, fellow employees Communicate with insurance carriers, practice staff and patients to obtain the information necessary to obtain authorization. Coordinates Peer to Peer reviews with third party payers. Generates appeals for chemotherapy denials. Generates appeals for oral medication denials. Interfaces with contracted payers and FMH finance department Provides assistance to other work teams. Maintains knowledge of payer rules, regulations and changes in authorization process. Maintain appropriate level of knowledge of the practice management software by continuous vendor training and third party education (e.g. payers, seminars, etc.). Performs other duties as assigned Required Knowledge, Skills and Abilities: Physician billing experience with demonstrated working knowledge of professional fee billing transactions and regulations, claims, insurance carriers, rejection and denial codes, error correction and re-posting and contractual adjustments; Completion of a high school diploma.College level courses preferred but not required; Prior experience and demonstrated competence with patient or customer information systems Must be able to define meaningful cause and effect situations related to professional fee claims rejections and denials; Demonstrated competency with medical procedural coding (CPT/ICD10); Must demonstrate excellent interpersonal skills, customer orientation, and the ability to interact with personnel of all levels within the organization and work within a multi-disciplinary team environment; Excellent oral and written communication; Professional manner and attire; Ability to clearly articulate administrative processes for policy implementation; Must be an intermediate to extensive PC user, and be able to maintain (create, edit, professional output) Microsoft Office products efficiently (Word, Excel, Power Point). Minimum Education, Training, and Experience Required: High School Diploma Must demonstrate and maintain current knowledge and skills in providing appropriate care/contact for patients in the following age groups:
- _Neonate (0 thru 30 days)
- _Infant (31 thru 12 months)
- _Child (13 months thru 12 years)
- X_Adolescent (13 years thru 17 years)
- X_Adult (18 years thru 65 years)
- X_Geriatric (66+ years)
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