Authorization & Eligibility Specialist (Infusion/Oncology)

gbmc; Cockeysville (MD); On-site; USD 52,000 - 76,000; Full time

Job summary

GBMC is seeking an Insurance Authorization Specialist to support infusion, oncology, and Dance Center patients. You will verify eligibility, obtain authorizations, and coordinate with billing and care teams to ensure coverage and timely approvals.

You will maintain up-to-date payer requirements, communicate with patients and providers, and support process improvements in a fast-paced environment.

Qualifications

• High School Diploma or GED required.
• Epic experience desired.
• Progressive insurance authorization experience preferred.
• Knowledge of ICD-10 and CPT coding practices.
• Understanding of complete revenue cycle.

Responsibilities

• Verify patient insurance eligibility, benefits, and authorization requirements for treatment plans.
• Collaborate with care teams to resolve commercial insurance issues and minimize denials.
• Obtain insurance authorization for treatment plans and document discussions in Epic.
• Coordinate with Infusion staff, Pharmacy Team, and Patient Financial Services to ensure timely authorizations.
• Review medical records for submission of payer requirements and medical necessity criteria.
• Maintain payer knowledge for pre-authorizations, certifications, and verifications.
• Respond to patient and staff inquiries promptly with professionalism.

Skills

Authorization processes

Insurance policies

Detail oriented

Team collaboration

Revenue cycle

ICD-10 CPT coding

EMR knowledge

Data analysis

Interpersonal skills

Time management

Planning and prioritization

Process development

Education

High School Diploma or GED

Tools

Epic

Microsoft Office

Job description

GBMC is seeking an Insurance Authorization Specialist to support infusion, oncology, and Dance Center patients. You will verify eligibility, obtain authorizations, and coordinate with billing and care teams to ensure coverage and timely approvals.

You will maintain up-to-date payer requirements, communicate with patients and providers, and support process improvements in a fast-paced environment.