Authorization Specialist: Pre-Auth & Insurance Verification

Astera Cancer Care; Northern (KY); Hybrid; USD 38,000 - 52,000; Full time

Job summary

OneOncology is seeking an Authorization Specialist to manage outpatient testing authorizations and billing coordination. You will verify insurance requirements, obtain pre-authorizations, and work with physicians, nurses and social workers to ensure reimbursement readies before procedures.

Responsibilities include updating EMR documentation, communicating with insurance coordinators, and assisting with denials and appeals to support patient access to care.

Qualifications

• High School diploma or equivalent.
• 1+ year of Prior Authorization experience.
• Medical insurance background required.
• Proficiency with MS Word, Excel and Outlook.
• Experience with EMR and billing systems.

Responsibilities

• Obtain pre-authorizations for physician orders for diagnostic testing or procedures as required by insurance carriers.
• Communicate with physicians and staff on reimbursement and pre-certification requirements.
• Maintain up-to-date documentation on patient accounts in EMR on authorization approvals/denials.
• Notify Insurance Authorization Coordinators of updated referrals and terminations as needed.
• Assist with denial follow-ups and appeals; coordinate with front office and imaging center staff.

Education

High School diploma or equivalent

Tools

MS Word

Excel

Outlook

Electronic Medical Record (EMR)

Billing systems (EBS)

Job description

OneOncology is seeking an Authorization Specialist to manage outpatient testing authorizations and billing coordination. You will verify insurance requirements, obtain pre-authorizations, and work with physicians, nurses and social workers to ensure reimbursement readies before procedures.

Responsibilities include updating EMR documentation, communicating with insurance coordinators, and assisting with denials and appeals to support patient access to care.