Oncology Prior Authorization Specialist

Cancer Center of South Florida; West Palm Beach (FL); On-site; USD 48,000 - 62,000; Full time

Job summary

The Oncology Authorization Specialist at Cancer Center of South Florida is responsible for obtaining, verifying, and maintaining prior authorizations for oncology services across Medical Oncology/Hematology, Infusion Therapy, Radiation Oncology and Surgical Oncology.

This role reviews insurance coverage, payer requirements, physician orders, treatment plans, and supporting clinical documentation to ensure authorization requirements and medical necessity criteria are satisfied prior to the

Qualifications

• Comprehensive knowledge of insurance authorization processes and payer requirements.
• Familiarity with CPT, HCPCS Level II, ICD-10-CM coding terminology.
• Experience with oncology services authorization workflows and portals.

Responsibilities

• Obtain and manage prior authorizations for oncology services.
• Review orders, treatment plans, and payer requirements for medical necessity.
• Submit documentation to payers; maintain authorization records in the EMR.
• Support patient financial clearance by confirming coverage and requirements.
• Monitor pending requests and follow up to prevent delays.
• Use payer portals and vendor systems to track authorizations.
• Validate approvals against services, codes, units, and dates of service.
• Update authorizations when treatment plans or sites of care change.
• Collaborate with physicians and Revenue Cycle to resolve issues.
• Maintain knowledge of payer policies and regulatory changes.

Skills

Prior authorizations

Insurance verification

EMR systems

Payer portals

Medical Oncology/Hematology

Oncology coding terminology

Education

High school diploma

Associate degree

Bachelor's degree

Job description

The Oncology Authorization Specialist at Cancer Center of South Florida is responsible for obtaining, verifying, and maintaining prior authorizations for oncology services across Medical Oncology/Hematology, Infusion Therapy, Radiation Oncology and Surgical Oncology.

This role reviews insurance coverage, payer requirements, physician orders, treatment plans, and supporting clinical documentation to ensure authorization requirements and medical necessity criteria are satisfied prior to the