Authorization Specialist

OneOncology•Charlotte, NC

4d•Remote

About The Position

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. 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.

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
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 (e.g., 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 to ensure medical necessity and completeness prior to 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 (EHR) 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