Oncology Authorization Specialist - Weekdays, Impactful

UPMC; Moon (VA); On-site; USD 45,000 - 60,000; Full time

Job summary

UPMC Hillman Cancer Center in Moon Township, PA is seeking an Authorization Specialist to ensure patients obtain timely access to needed care. This full-time role supports our medical oncology network across Butler, Beaver, Cranberry, McCandless, Pittsburgh (St.

Margaret), and Natrona Heights. You will manage denials and pre-authorizations, coordinate with physicians and payors, and use UPMC systems to submit data and verify coverage.

Qualifications

• Experience with pre-authorizations and denials processes.
• Ability to interpret medical records and eligibility criteria.

Responsibilities

• Reviews and interprets medical records to pre-authorize procedures.
• Determines medical necessity using payor criteria and regulations.
• Codes diagnoses and procedures using ICD-9-CM, CPT, and HCPCS Level II.
• Submits demographic and clinical data to payors to request approval for services.

Skills

Prior authorization

Attention to detail

Team collaboration

Communication skills

Process compliance

Tools

UPMC systems

Job description

UPMC Hillman Cancer Center in Moon Township, PA is seeking an Authorization Specialist to ensure patients obtain timely access to needed care. This full-time role supports our medical oncology network across Butler, Beaver, Cranberry, McCandless, Pittsburgh (St.

Margaret), and Natrona Heights. You will manage denials and pre-authorizations, coordinate with physicians and payors, and use UPMC systems to submit data and verify coverage.