Authorization Specialist

OneOncology•Charlotte, NC

19h•Remote

About The Position

The Authorization Specialist obtains and verifies prior authorizations for oncology services, including chemotherapy, radiation therapy, imaging, and supportive care. The role helps secure timely approvals, minimize treatment delays, and meet payer requirements while supporting high-quality patient care. The specialist reviews provider orders, treatment plans, and clinical documentation; communicates with payers and specialty pharmacies; tracks authorizations; assists with denials and appeals; and maintains accurate records in electronic health record and practice management systems. The position is remote and reports to the Authorization Manager.

Requirements

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.
Strong communication and interpersonal skills.
Ability to manage multiple priorities in a fast-paced environment.
Problem-solving and critical-thinking skills.
High level of accuracy and attention to detail.
Customer service orientation with a patient-centered approach.

Nice To Haves

Experience in oncology or specialty practice.
Certification in medical billing/coding, such as CPC, CPAR, or similar.
Familiarity with chemotherapy regimens and oncology-specific authorization processes.

Responsibilities

Obtain prior authorizations for oncology treatments, procedures, medications, and diagnostic services in a timely manner.
Review provider orders, treatment plans, and clinical documentation for medical necessity and completeness before submission.
Communicate with insurance companies, payers, and specialty pharmacies to 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.
Maintain accurate and detailed records in the electronic health record and/or practice management system.
Verify insurance benefits, coverage limitations, and patient eligibility as needed.
Ensure compliance with payer guidelines, regulatory requirements, and organizational policies.
Identify trends in denials or delays and escalate issues to leadership for process improvement.