Oncology & Hematology Authorization Specialist

Frederick Health; Frederick (MD); On-site; USD 25,000 - 33,000; Full time

Job summary

Frederick Health is seeking a full-time Oncology and Hematology Authorization Specialist to monitor, obtain and pre-authorize medical services including phlebotomy, IV infusion, oral medications, radiology and genetic testing. The role requires communication with patients, physicians, and payers to secure approvals and resolve denials.

You will coordinate peer-to-peer reviews, prepare appeals for chemotherapy and oral therapy denials, and stay current with payer rules and FH compliance standards

Qualifications

• High School Diploma required.
• Knowledge of professional fee billing regulations and insurance terminology.
• Experience with medical billing systems and payer denials.

Responsibilities

• Obtain pre-authorizations for phlebotomy, IV infusion, oral meds, radiology, and genetic testing.
• Coordinate peer-to-peer reviews with payers.
• Generate appeals for chemotherapy and oral therapy denials.
• Maintain knowledge of payer rules and changes in authorization processes.
• Interface with payers, practice staff, and FMH finance department.

Skills

Medical billing

Interpersonal skills

Communication skills

Customer service

Education

High School Diploma

Tools

Microsoft Office

Job description

Frederick Health is seeking a full-time Oncology and Hematology Authorization Specialist to monitor, obtain and pre-authorize medical services including phlebotomy, IV infusion, oral medications, radiology and genetic testing. The role requires communication with patients, physicians, and payers to secure approvals and resolve denials.

You will coordinate peer-to-peer reviews, prepare appeals for chemotherapy and oral therapy denials, and stay current with payer rules and FH compliance standards