Remote Insurance Authorization Specialist - Oncology

US Oncology Inc.; Denton (TX); Remote; USD 48,000 - 60,000; Full time

Job summary

The US Oncology Network is seeking an Insurance Authorization Specialist to support the Medical Authorizations Department at Texas Oncology in Denton, TX. This remote full-time role requires coordinating pre-certifications and ensuring timely reimbursement for chemotherapy treatments.

Level 1 or Sr depending on experience; requires strong medical insurance verification skills and ability to liaise between patients, physicians, and payers within a regulated oncology setting.

Qualifications

• High school degree or equivalent.
• Associates degree in Healthcare, LPN state license and registration preferred.
• Minimum three (3) years medical insurance verification and authorization preferred.
• Minimum three (3) years medical insurance verification and authorization and two (2) years clinical review experience required.

Responsibilities

• Reviews chemotherapy regimen for medical necessity and pathway adherence.
• Communicates with nursing and medical staff about restrictions or payer issues.
• Updates coding/payer guidelines for clinical staff and tracks pathways.

Skills

Medical insurance verification

Pre-certification

Clinical liaison

Payer communications

Education

High school diploma or GED

Associates degree in Healthcare

LPN license (preferred)

Job description

The US Oncology Network is seeking an Insurance Authorization Specialist to support the Medical Authorizations Department at Texas Oncology in Denton, TX. This remote full-time role requires coordinating pre-certifications and ensuring timely reimbursement for chemotherapy treatments.

Level 1 or Sr depending on experience; requires strong medical insurance verification skills and ability to liaise between patients, physicians, and payers within a regulated oncology setting.