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:Â Authorization SpecialistÂ
Department:Â Revenue Cycle ManagementÂ
Location:Â Carolina Oncology Specialists-RemoteÂ
Reports To:Â Authorization ManagerÂ
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Position SummaryÂ
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.Â
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Key ResponsibilitiesÂ
Obtain prior authorizations for oncology treatments, procedures, medications, and diagnostic services in a timely mannerÂ
Review provider orders, treatment plans, and clinical documentation to ensure medical necessity and completeness prior to submissionÂ
Communicate with insurance companies, payers, and specialty pharmacies to secure approvals and document authorization detailsÂ
Track authorization status and follow up to prevent delays in patient careÂ
Collaborate with physicians, nurses, and clinical staff to resolve authorization issues or denialsÂ
Submit appeals and provide supporting documentation for denied services when appropriateÂ
Maintain accurate and detailed records in the electronic health record (EHR) and/or practice management systemÂ
Verify insurance benefits, coverage limitations, and patient eligibility as neededÂ
Ensure compliance with payer guidelines, regulatory requirements, and organizational policiesÂ
Identify trends in denials or delays and escalate issues to leadership for process improvementÂ
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QualificationsÂ
Required:Â
High school diploma or equivalentÂ
Minimum of 2–3 years of experience in healthcare prior authorizations, medical billing, or revenue cycle operationsÂ
Knowledge of insurance plans, including Medicare, Medicaid, and commercial payersÂ
Experience working with EHR and practice management systemsÂ
Strong attention to detail and organizational skillsÂ
Preferred:Â
Experience in oncology or specialty practiceÂ
Certification in medical billing/coding (e.g., CPC, CPAR, or similar)Â
Familiarity with chemotherapy regimens and oncology-specific authorization processesÂ
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Key CompetenciesÂ
Strong communication and interpersonal skillsÂ
Ability to manage multiple priorities in a fast-paced environmentÂ
Problem-solving and critical thinkingÂ
High level of accuracy and attention to detailÂ
Customer service orientation with a patient-centered approachÂ
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Working ConditionsÂ
Primarily office-based or remote work environmentÂ
Frequent use of computers, phones, and healthcare systemsÂ
May require extended periods of sitting and screen timeÂ
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Physical RequirementsÂ
Ability to sit for extended periodsÂ
Ability to use standard office equipment, including computers and telephonesÂ
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