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American Addiction Centers

Leading nationwide provider of substance use treatment offering a full continuum of care. #FreedomFromAddiction

Advance Authorization Specialist

Billing SpecialistBilling SpecialistFull TimeRemoteMid LevelTeam 1,001-5,000Since 2012H1B SponsorCompany SiteLinkedIn

Location

United States

Posted

59 days ago

Salary

$22 - $33 / hour

Seniority

Mid Level

No structured requirement data.

Job Description

Advance Authorization Specialist

American Addiction Centers

Department: 13556 Enterprise Revenue Cycle - National Service Line : Oncology: PreArrival Authorization Status: Full time Benefits Eligible: Yes Hours Per Week: 40 Schedule Details/Additional Information: Monday-Friday (8-4:30 or 8:30-5) remote Pay Range $21.85 - $32.80 Bachelor's Degree or 3 years of authorization experience required. Remote Major Responsibilities - Assess time sensitive Referral Work Queues to obtain highly complex authorizations including IP/OP Chemotherapy, Radiology, specifically related to Oncology treatment plans, IP/OP Surgeries, Molecular and Genetic Laboratory Testing, specialty related PT/OT and Speech Therapy, Psychiatry, Neuro/Psych Evaluations, and Rehab evaluations. - Manage high volume Stat request mailbox for all oncology facilities for potential life altering, high-cost treatment and procedures within a short time frame. Expected treatment within 1-3 days. - Interpret medical records to determine initial and disease progression to prove medical necessity for ordered services and complete on-line clinical requests for advanced authorization. - Manage Advocate Health preferred drug list (chemotherapy/immunotherapy/supportive drugs) with payors and correlate changes with oncology pharmacy. - Manage Advocate Health drug formulary changes with authorization updates with payors. - Review laboratory panels for Bone Marrow Biopsies to authorize Molecular Lab Studies, diagnosis specific. - Review and address monthly denials for Chemotherapy Drugs, Molecular Labs and surgeries with payors and Advocate Health Denial Management Teams (HBO/PBO). Minimum Job Requirements Education Bachelor's Degree or 3 years of authorization experience required. Work Experience Bachelor's Degree or 3 years of authorization experience required. Knowledge / Skills / Abilities - General knowledge and background in CPT and HCPCS Coding. - Must be proficient with medical terminology and be familiar with clinical considerations as these relate to oncology services. - Excellent written and oral communication skills required. - Microsoft Excel, Word, Epic experience preferred. - Databases, hospital registration, billing and clinical systems preferred. Physical Requirements and Working Conditions - Work requires typing, filing, use of telephone and sitting for prolonged periods of time. - Should be able to bend and lift up to 10lbs. DISCLAIMER All responsibilities and requirements are subject to possible modification to reasonably accommodate individuals with disabilities. This job description in no way states or implies that these are the only responsibilities to be performed by an employee occupying this job or position. Employees must follow any other job-related instructions and perform any other job-related duties requested by their leaders. Our Commitment to You: Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including: Compensation - Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training - Premium pay such as shift, on call, and more based on a teammate's job - Incentive pay for select positions - Opportunity for annual increases based on performance Benefits and more - Paid Time Off programs - Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability - Flexible Spending Accounts for eligible health care and dependent care expenses - Family benefits such as adoption assistance and paid parental leave - Defined contribution retirement plans with employer match and other financial wellness programs - Educational Assistance Program About Advocate Health Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.

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Full TimeRemoteTeam 10,001+Since 1969H1B Sponsor

Labcorp is seeking a Remote Prior Authorization Specialist I to join our team! Work Schedule: Monday - Friday 8:00 AM - 5:00 PM EST Job Responsibilities - Well-versed in pre-authorization processes and policies to respond clearly to high-volume billing tasks and inquiries - Maintain appropriate response time in various communication platforms (Example: phone calls, chats, emails, portal inquiries, etc) - Identify issues and suggest potential improvements - Collaborate with your team and develop best practices to ensure we are providing the best service and experience to all customers - Maintain an assigned schedule, and be flexible with daily schedules when business needs change - Examine incoming orders to ensure completeness and accuracy of required documentation for prior authorization - Work directly with various vendors to ensure successful submissions of prior authorizations - Monitor the status of prior authorization requests, follow up on pending cases, and initiate follow-ups, if necessary, to ensure timely approvals - Stay informed about insurance policies and guidelines, ensuring that all prior authorization requests align with the necessary criteria - Maintain accurate records of prior authorization requests, approvals, and denials. Enter relevant information into databases - Participate in projects that extend beyond your day-to-day to stretch you to think outside the box Minimum Qualifications - High school diploma or GED or equivalent - 1 year or more years insurance claims or pre-authorization or medical benefits work experience Preferred Qualifications - Associate’s degree - 1 year or more clinical laboratory Revenue Cycle Management (RCM) experience ​ Additional Job Standards - Ability to work remotely from a private, quiet workspace - Reliable high‑speed internet connection (minimum 50 Mbps) - Proficiency with Microsoft Office (Word, Excel, Outlook) - Strong customer service, time management, and organizational skills - Excellent verbal and written communication abilities - High attention to detail with the ability to manage multiple priorities - Solid understanding of medical terminology, insurance guidelines, and healthcare regulations - Self‑motivated, collaborative, and willing to take initiative to get work done - Strong work ethic with flexibility and a commitment to supporting positive patient outcomes - Enjoys problem‑solving in a fast‑paced, team‑oriented, and evolving environment - Provide responsive, professional support to providers, patients, and insurance representatives regarding prior authorization status and requirements Application Window Closes: 4/20/2026 Pay Range: $17.75 - $19.50 All job offers will be based on a candidate’s skills and prior relevant experience, applicable degrees/certifications, as well as internal equity and market data. At Labcorp we have a passion for helping people live happy and healthy lives. Every day, we provide vital information that helps our clients and patients understand their health. If you are passionate about helping people and have a drive for service, then Labcorp could be a great next career step! The Prior Authorization Specialist supports Labcorp’s Prior Authorization program by completing payer‑required pre‑billing activities to ensure timely and accurate payment for services. This role reviews medical policies, initiates prior authorizations, performs benefit investigations, provides patient cost estimates, and responds to billing‑related inquiries from clinicians and patients while collaborating with Sales, Operations, Billing, and Lab teams to support patient and client needs. 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Qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex (including pregnancy, childbirth, or related medical conditions), family or parental status, marital, civil union or domestic partnership status, sexual orientation, gender identity, gender expression, personal appearance, age, veteran status, disability, genetic information, or any other legally protected characteristic. Additionally, all qualified applicants with arrest or conviction records will be considered for employment in accordance with applicable law. We encourage all to apply If you are an individual with a disability who needs assistance using our online tools to search and apply for jobs, or needs an accommodation, please visit our accessibility site or contact us at Labcorp Accessibility. For more information about how we collect and store your personal data, please see our Privacy Statement.

United States
$18 - $20 / hour
Full TimeRemoteTeam 10,001+Since 1849H1B Sponsor

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United States
$108K - $250K / year
Job Closed

Sr. Drug Authorization Specialist

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Established in 2018, OneOncology is working to redefine how cancer care is delivered in communities across the United States. As a dynamic network of leading on

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United States
Job Closed
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Destination Specialist

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True Adventure Travel is a leading travel company that specializes in creating unique and unforgettable travel experiences for our clients. We are dedicated to providing personalized and high-quality services to our customers.

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United States