Authorization Specialist

Carolina Oncology Specialists -
Hickory, NC

Quick Apply

Job Details

Full-time
4 hours ago

Qualifications

Medicare
Practice management software
High school diploma or GED
Medicaid health insurance
Medicaid

Full Job Description

Carolina Oncology Specialists has been providing compassionate, patient-centered care since 1983, delivering high-quality oncology and hematology services tailored to each individual's needs. Patients benefit from the convenience of receiving chemotherapy treatments in our clinics, along with expert diagnosis, treatment, and management of a wide range of blood disorders.

Why Join Us?

We are seeking talented, compassionate, and highly motivated individuals who are passionate about making a difference. At Carolina Oncology Specialists, you'll have the opportunity to support the meaningful work of community oncology while helping provide exceptional care and hope to the patients and families we serve. Join a team dedicated to clinical excellence, collaboration, and improving lives every day.

Job Description:

Job Title: Authorization Specialist
Department: Revenue Cycle Management
Location: Carolina Oncology Specialists-Remote
Reports To: Authorization Manager

Position Summary

The Authorization Specialist is responsible for obtaining and verifying prior authorizations for oncology services, including chemotherapy, radiation therapy, imaging, and supportive care. This role ensures timely approvals, minimizes treatment delays, and maintains compliance with payer requirements while supporting high-quality patient care.

Key Responsibilities

Obtain prior authorizations for oncology treatments, procedures, medications, and diagnostic services in a timely manner

Review provider orders, treatment plans, and clinical documentation to ensure medical necessity and completeness prior to submission

Communicate with insurance companies, payers, and specialty pharmacies to secure approvals and document authorization details

Track authorization status and follow up to prevent delays in patient care

Collaborate with physicians, nurses, and clinical staff to resolve authorization issues or denials

Submit appeals and provide supporting documentation for denied services when appropriate

Maintain accurate and detailed records in the electronic health record (EHR) and/or practice management system

Verify insurance benefits, coverage limitations, and patient eligibility as needed

Ensure compliance with payer guidelines, regulatory requirements, and organizational policies

Identify trends in denials or delays and escalate issues to leadership for process improvement

Qualifications

Required:

High school diploma or equivalent

Minimum of 2–3 years of experience in healthcare prior authorizations, medical billing, or revenue cycle operations

Knowledge of insurance plans, including Medicare, Medicaid, and commercial payers

Experience working with EHR and practice management systems

Strong attention to detail and organizational skills

Preferred:

Experience in oncology or specialty practice

Certification in medical billing/coding (e.g., CPC, CPAR, or similar)

Familiarity with chemotherapy regimens and oncology-specific authorization processes

Key Competencies

Strong communication and interpersonal skills

Ability to manage multiple priorities in a fast-paced environment

Problem-solving and critical thinking

High level of accuracy and attention to detail

Customer service orientation with a patient-centered approach

Working Conditions

Primarily office-based or remote work environment

Frequent use of computers, phones, and healthcare systems

May require extended periods of sitting and screen time

Physical Requirements

Ability to sit for extended periods

Ability to use standard office equipment, including computers and telephones

Quick Apply

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