Oncology Authorization Specialist

June 12, 2024

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Job Title: Oncology Authorisation Specialist

Report To: Team Leader

Experience: 1 - 5 Years

Qualification: PUC

Location: Bangalore / Coimbatore

Shift Time: 09:00 AM - 06:00 PM

Mode: Work from office

Terms-Fulltime/Part time/Contractual: Full-Time

Job Summary

As an Oncology Authorization Specialist, you will be crucial in obtaining and managing authorizations for oncology-related treatments and procedures. This position requires a deep understanding of insurance protocols, Clinical questions, and oncology treatment processes.

Key Responsibilities

  • Obtain pre-authorization for complex oncology treatments, medications, and procedures from insurance providers (Chemo Drugs).
  • Demonstrate proficiency in understanding and navigating various oncology regimens, drugs, and dosages.
  • Collaborate with healthcare providers, physicians, and insurance companies to ensure timely authorization approvals.
  • Verify insurance coverage and communicate with patients regarding authorization status and any potential financial responsibilities.
  • Maintain accurate and up-to-date records of authorization requests, approvals, and denials.
  • Stay informed about changes in insurance policies, coding regulations, and reimbursement processes related to oncology services.
  • Utilize and navigate authorization portals like Carelon, Evicore, Optum, Availity, etc., to streamline the authorization process.

Mandatory Skills

  • Excellent communication and interpersonal skills.
  • Detail-oriented with the ability to manage multiple tasks simultaneously.
  • Proficient in using NextGen & Epic.

Desired skills

  • Minimum of [2] years of experience in oncology authorization or a similar role.
  • Strong knowledge of RCM, insurance procedures, and oncology treatment processes.
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