Oncology Authorization Specialist II (Hybrid)

Elevance Health; Florida; Hybrid; USD 25,000 - 33,000; Full time

Job summary

Elevance Health's BioPlus Specialty Pharmacy in Lake Mary, FL seeks an Authorization Representative II - Oncology to manage prior authorizations for patients as required by health plans. The role emphasizes accurate info gathering, medical necessity documentation, and cross‑department collaboration, with emphasis on oncology and specialty pharmacy workflows.

The position is non-management, non-exempt, with a hybrid schedule (in-office 1–2 days/week) and a strong focus on patient access and

Qualifications

• Requires a HS diploma or GED and a minimum of 2 years of experience processing pharmacy prior authorizations, and a minimum of 1 year of experience applying knowledge of Medicare, Medicaid and Managed Care reimbursement guidelines; or any combination of education and experience which would provide an equivalent background.

Responsibilities

• Reviews accuracy and completeness of prior authorization information requested and ensures supporting documents are present and meet company set standards.
• Assists with the completion of medical necessity documentation to expedite approvals and ensures that appropriate follow up is performed.
• Collaborates with other departments to assist in obtaining prior authorizations/appeals.
• Document insurance company interactions and all prior authorization information in system.
• Reviews insurance denials and submit appeals as permitted by payor.
• Contacts physician offices as needed to obtain demographic information or medical data.

Skills

Oncology experience

Specialty pharmacy experience

Medical terminology training

Education

HS diploma or GED

Job description

Elevance Health's BioPlus Specialty Pharmacy in Lake Mary, FL seeks an Authorization Representative II - Oncology to manage prior authorizations for patients as required by health plans. The role emphasizes accurate info gathering, medical necessity documentation, and cross‑department collaboration, with emphasis on oncology and specialty pharmacy workflows.

The position is non-management, non-exempt, with a hybrid schedule (in-office 1–2 days/week) and a strong focus on patient access and