Oncology Authorization Specialist - Fast Approvals

Hugh Chatham Health; Concord (NC); On-site; USD 45,000 - 68,000; Full time

Job summary

Advocate Health is seeking an on-site, full-time Authorization Specialist for the Infusion Clinic in Cabarrus County. The role requires 40 hours per week, Monday–Friday, 7:30 am–4:00 pm.

The ideal candidate has a Bachelor's Degree or 3 years of authorization experience, with CPT/HCPCS coding knowledge, medical terminology, and strong communication skills. Epic experience and proficiency in Excel are preferred.

Qualifications

• General knowledge of CPT and HCPCS coding.
• Familiar with medical terminology as it relates to oncology services.
• Excellent written and oral communication skills.

Responsibilities

• Assess time sensitive referral work queues to obtain highly complex authorizations including IP/OP chemotherapy, radiology, oncology treatment plans, surgeries, molecular and genetic testing, and related PT/OT and therapy evaluations.
• Manage high volume stat request mailbox for oncology facilities for potential life-changing, high-cost treatments within short timeframes (1-3 days).
• Interpret medical records to determine disease progression and medical necessity for ordered services and complete online requests for advanced authorization.
• Coordinate Advocate Health drug formulary changes with payors and oncology pharmacy; track payor authorization updates.
• Review lab panels for bone marrow biopsies to authorize molecular lab studies.
• Address monthly denials for chemotherapy drugs, molecular labs, and surgeries with payors and denial management teams.

Skills

CPT/HCPCS coding

Medical terminology

Communication skills

Education

Bachelor's Degree or 3 years authorization experience

Tools

Epic

Microsoft Excel

Job description

Advocate Health is seeking an on-site, full-time Authorization Specialist for the Infusion Clinic in Cabarrus County. The role requires 40 hours per week, Monday–Friday, 7:30 am–4:00 pm.

The ideal candidate has a Bachelor's Degree or 3 years of authorization experience, with CPT/HCPCS coding knowledge, medical terminology, and strong communication skills. Epic experience and proficiency in Excel are preferred.