Oncology Authorization Specialist — Timely Care Champion

Southwest Women's Oncology, Inc.; Albuquerque (NM); Sur place; USD 42 000 - 62 000; Plein temps

Avantages offerts par ce poste

Health benefits

401(k)

Paid time off

Professional development and education

Growth opportunities

Résumé du poste

Southwest Women's Oncology, Inc. in Albuquerque, NM is seeking a Prior Authorization Specialist to secure timely insurance authorizations for infusion therapies, surgeries, and medications.

You will collaborate with providers, nurses, schedulers, pharmacy, and billing to ensure approvals are in place before treatments. The role requires 2+ years in healthcare authorization, EMR and payer portal proficiency, and strong communication.

Qualifications

• 2+ years of prior authorization experience in healthcare revenue cycle.
• Experience with medication and procedural authorizations.
• Knowledge of commercial insurance, Medicare, Medicaid, and managed care plans.

Responsabilités

• Obtain prior authorizations for infusion therapies (chemotherapy, immunotherapy, biologics, and supportive medications), surgical procedures, and oral and specialty medications.
• Submit authorization requests via payer portals, electronic systems, phone, and fax with complete and payer-compliant documentation.
• Track authorization status across all active requests and proactively follow up with insurance carriers to secure timely determinations.
• Ensure authorizations are in place prior to scheduled infusion appointments, clinic visits, surgeries, and medication dispensing-without exception.

Connaissances

Prior authorization

EMR systems

Payer portals

Communication

Formation

High school diploma

Associate degree preferred

Description du poste

Southwest Women's Oncology, Inc. in Albuquerque, NM is seeking a Prior Authorization Specialist to secure timely insurance authorizations for infusion therapies, surgeries, and medications.

You will collaborate with providers, nurses, schedulers, pharmacy, and billing to ensure approvals are in place before treatments. The role requires 2+ years in healthcare authorization, EMR and payer portal proficiency, and strong communication.