Oncology Access & Authorization Specialist

Memorial Healthcare System; Town of Florida (NY); On-site; USD 42,000 - 60,000; Full time

Job summary

Memorial Healthcare System in Hollywood, Florida is seeking a Referrals and Authorizations Coordinator to secure prior authorizations and primary care referrals for inpatient and outpatient services, including surgeries and procedures.

This role ensures timely access to care, supports accurate reimbursement, and collaborates with clinical and scheduling teams, while navigating Medicare, Medicaid, and commercial payer guidelines across practice and hospital billing.

Qualifications

• Knowledge of medical terminology and insurance authorization processes.
• Familiarity with payer portals, EMR systems, and healthcare billing systems.
• Strong interpersonal and communication skills with attention to detail.
• Ability to manage multiple tasks in a fast-paced environment.

Responsibilities

• Verifies accuracy of referring provider to ensure data integrity and accuracy.
• Serves as liaison between providers, patients, and insurance companies to resolve authorization and/or referral-related issues.
• Ensures timely follow-up on pending authorizations to prevent treatment delays.
• Collaborates with clinical and scheduling teams regarding authorization status to support treatment planning and scheduling.
• Understands and applies payer-specific guidelines for Medicare, Medicaid, and commercial insurance requirements for both practice and hospital billing.
• Obtains and documents prior authorizations and referrals for all required services.
• Processes incoming and outgoing referrals from providers, ensuring documentation and approvals are in place.
• Verifies insurance eligibility and benefits for patients, including coverage for specialty medications and services.

Skills

Attention to detail

HIPAA compliance

Insurance verification

Communication

Teamwork

Accountability

Quality focus

Data integrity

Organizational skills

Problem solving

Patient-centered care

Productivity

Adaptability

Standards of behavior

Verifying insurance

Workload management

Education

High School Diploma or Equivalent

Associate’s degree preferred

Tools

EMR systems

Payer portals

Job description

Memorial Healthcare System in Hollywood, Florida is seeking a Referrals and Authorizations Coordinator to secure prior authorizations and primary care referrals for inpatient and outpatient services, including surgeries and procedures.

This role ensures timely access to care, supports accurate reimbursement, and collaborates with clinical and scheduling teams, while navigating Medicare, Medicaid, and commercial payer guidelines across practice and hospital billing.