• Job Description

  Req#: R-0000024665
  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 Specialist
  Department: Revenue Cycle Management
  Location: Carolina Oncology Specialists-Remote
  Reports To: Authorization Manager
  
  Position Summary
  
  The 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 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
  
  
  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 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
  
  
  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

• About the company

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