Remote Authorization Specialist for Diagnostics Reimbursement

OneOncology, LLC; United States; Remote; USD 42,000 - 54,000; Full time

Job summary

OneOncology, LLC is seeking an Authorization Specialist to manage all administrative aspects of outpatient diagnostic testing authorization and pre-certifications. The role ensures patient insurance requirements are met for reimbursement and collaborates with physicians, nurses, and social workers to assess financial feasibility.

The candidate will maintain knowledge of authorization processes, payer guidelines, and denial management while training staff and supporting department projects.

Qualifications

• High school diploma or equivalent required.
• At least 1 year of prior authorization experience.
• Medical insurance background required, urology experience preferred.
• Strong proficiency with MS Office and healthcare information systems.

Responsibilities

• Obtain pre-authorizations for diagnostic testing per insurer.
• Communicate with physicians and staff about pre-certification needs.
• Maintain up-to-date EMR and billing documentation.
• Collaborate with front office and imaging centers to resolve denials.
• Stay current on payer guidelines and denial management.

Skills

Prior Authorization experience

Medical insurance background

MS Word / Excel / Outlook

Customer service skills

Attention to detail

Multi-tasking

Communication skills

Education

High School diploma or equivalent

Tools

EMR systems

EBS / billing systems

Job description

OneOncology, LLC is seeking an Authorization Specialist to manage all administrative aspects of outpatient diagnostic testing authorization and pre-certifications. The role ensures patient insurance requirements are met for reimbursement and collaborates with physicians, nurses, and social workers to assess financial feasibility.

The candidate will maintain knowledge of authorization processes, payer guidelines, and denial management while training staff and supporting department projects.