Oncology Authorization Specialist (Remote)

COS Carolina Oncology Specialists, P.A.; Charlotte (NC); Remote; USD 45,000 - 60,000; Full time

Job summary

Carolina Oncology Specialists in North Carolina seeks an Authorization Specialist to obtain and verify prior authorizations for oncology services, ensuring timely approvals and compliance with payer requirements. You will review orders for medical necessity, coordinate with physicians and staff, and maintain accurate records in the EHR/PM system to support efficient patient care and minimize delays.

Strong attention to detail and communication with payers are essential, especially for complex

Qualifications

• 2-3 years of experience in healthcare prior authorizations or revenue cycle.
• Knowledge of Medicare, Medicaid, and commercial payers.
• Certification in medical billing/coding (CPC, CPAR or similar) preferred.
• Familiarity with oncology or specialty-practice authorization processes is preferred.

Responsibilities

• Obtain prior authorizations for oncology services in a timely manner.
• Review orders and treatment plans for medical necessity prior to submission.
• Communicate with payers to secure approvals and document authorization details.
• Track authorization status and follow up to prevent delays in patient care.
• Collaborate with physicians and staff to resolve authorization issues or denials.
• Submit appeals with supporting documentation for denials when appropriate.
• Maintain accurate records in the EHR and/or practice management system.
• Verify insurance benefits and patient eligibility as needed.
• Ensure compliance with payer guidelines and regulatory requirements.
• Identify trends in denials or delays and escalate to leadership for process improvement.

Skills

Healthcare prior authorizations

Medical billing

Communication skills

Attention to detail

Team collaboration

Education

High school diploma or equivalent

Medical billing/coding certification (CPC/CPAR preferred)

Tools

EHR/Practice Management Systems

Job description

Carolina Oncology Specialists in North Carolina seeks an Authorization Specialist to obtain and verify prior authorizations for oncology services, ensuring timely approvals and compliance with payer requirements. You will review orders for medical necessity, coordinate with physicians and staff, and maintain accurate records in the EHR/PM system to support efficient patient care and minimize delays.

Strong attention to detail and communication with payers are essential, especially for complex