Oncology Pre-Access & Authorization Specialist

AdventHealth; Orlando (FL); On-site; USD 25,000 - 39,000; Full time

Benefits offered by this job

Benefits from Day One: Medical, Dental

Paid Time Off from Day One

403-B Retirement Plan

Parental Leave

Job summary

AdventHealth in Orlando, FL is seeking a medical billing specialist to verify insurance, obtain pre-auths for chemotherapy, and communicate payor requirements. You will review clinical data and ensure coding aligns with CMS and NCCN guidelines, coordinating with service lines to confirm medical necessity.

The role requires strong communication, accuracy, and experience in the oncology revenue cycle, with a focus on timely authorization and benefits verification for patients.

Qualifications

• High School Diploma or equivalent required.
• Field of study: Medical Billing/Claims course.
• 1+ year in customer service or direct patient access preferred.
• Oncology revenue cycle experience preferred.
• Provisional Pharmacy Technician license preferred.
• CRCR certification preferred.

Responsibilities

• Alert physician offices to issues with verifying insurance and communicates situations where medical necessity is not met.
• Review clinical data such as patient pathology reports, scans, lab results, and prior treatments against insurance payor guidelines.
• Obtain initial and subsequent pre-authorizations for chemotherapy treatments and research protocols.
• Verify insurance eligibility and benefits within established timeframes.

Skills

Mature judgement

MS Office

Office equipment

Multitasking

Professional communication

Healthcare environment knowledge

HIPAA compliance

Customer service

Insurance knowledge

EMR systems

English proficiency

Education

High School Diploma

Medical Billing Claims Specialist Course

Tools

MS Office

EMR system

Job description

AdventHealth in Orlando, FL is seeking a medical billing specialist to verify insurance, obtain pre-auths for chemotherapy, and communicate payor requirements. You will review clinical data and ensure coding aligns with CMS and NCCN guidelines, coordinating with service lines to confirm medical necessity.

The role requires strong communication, accuracy, and experience in the oncology revenue cycle, with a focus on timely authorization and benefits verification for patients.