Oncology Prior Authorization Specialist: Timely Care

Southwest Womens Oncology Inc; Albuquerque (NM); Vor Ort; USD 55.000 - 75.000; Vollzeit

Benefits dieser Stelle

Health benefits

401(k)

Paid time off

Professional development

Zusammenfassung

Southwest Women's Oncology + Optimum Infusion in Albuquerque, NM seeks a detail‑driven Prior Authorization Specialist to manage insurance approvals for infusion therapies, surgeries, and specialty medications. You will coordinate with providers, schedulers, pharmacy, and billing to secure complete, payer‑compliant documentation and timely determinations.

Success means on‑time treatment delivery and minimized delays, achieved through accurate submission, proactive follow‑up, and adherence to

Qualifikationen

• 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.
• Proficiency with EMR systems and insurance payer portals.

Aufgaben

• Obtain prior authorizations for infusion therapies, surgical procedures, and oral/specialty medications.
• Submit using payer portals, electronic systems, phone, and fax with complete documentation.
• Track status and follow up with carriers to secure timely determinations.
• Ensure authorizations are in place prior to scheduled appointments and dispensing.

Kenntnisse

Prior authorization experience

EMR systems

Payer portals

Communication skills

Organization

Ausbildung

High school diploma or equivalent

Associate's degree preferred

Jobbeschreibung

Southwest Women's Oncology + Optimum Infusion in Albuquerque, NM seeks a detail‑driven Prior Authorization Specialist to manage insurance approvals for infusion therapies, surgeries, and specialty medications. You will coordinate with providers, schedulers, pharmacy, and billing to secure complete, payer‑compliant documentation and timely determinations.

Success means on‑time treatment delivery and minimized delays, achieved through accurate submission, proactive follow‑up, and adherence to