Drug Authorization Specialist

Drug Authorization SpecialistThis position will start in late November 2026. The Drug Authorization Specialist, with direct supervision of the Prior Authorization Supervisor, is responsible for managing all work related to drug authorizations for all injectable drug treatment plans ordered by Dana Farber Cancer Institute providers using knowledge of payer coverage policies and applies appropriate payer guidelines to all aspects of drug prior authorization work.Located in Boston and the surrounding communities, Dana-Farber Cancer Institute is a leader in life changing breakthroughs in cancer research and patient care. We are united in our mission of conquering cancer, HIV/AIDS, and related diseases.

We strive to create an inclusive, diverse, and equitable environment where we provide compassionate and comprehensive care to patients of all backgrounds, and design programs to promote public health particularly among high-risk and underserved populations. We conduct groundbreaking research that advances treatment, we educate tomorrow's physician/researchers, and we work with amazing partners, including other Harvard Medical School-affiliated hospitals.Responsibilities:Manages referral and authorizations information as assigned through daily work queues and documents activities into the hospital information system; may require contacting physician offices and/or payors for referrals and authorizations via phone calls and/or websitesEnsures accurate and timely responses to all referral requestsDetermines the pertinent clinical information needed to send to PCP and/or insurance office for approvals. Coordinates referral requests with PCPs and their practices, specialty practices, and with other clinical consultants as appropriate.Engages patients by telephone to discuss referral requests when necessaryVerifies insurance eligibility and benefits using automated eligibility systems, payer websites, and calls to the insurance carriers; identify and resolve invalid insurance for patients and/or escalate patients as needed for Financial Counselor interventionConfirms, updates patient demographic, financial, and other relevant personal information into the hospital information system (EPIC)Communicates regularly with physicians and other medical providers regarding clinical clarifications for referrals and authorizations, medical necessity requirements, and facilitating conversations with different payersDocuments daily activities in a timely, thorough, and accurate manner into the hospital information systemComplies with all Dana-Farber and HIPAA confidentiality policiesKnowledge, Skills, and Abilities Required:Basic knowledge of insurance plans, medical registration or billing systemsBasic knowledge of Epic or other hospital information systemsCustomer service and communication skills, both written and verbalGood judgment, tact, and sensitivityRelationship building skills and collaborationProficient use of Microsoft officeAbility to prioritize work and meet pre-determined deadlines, with directionAbility to work with sensitive patient information and maintain confidentialityMinimum Job Qualifications:The position requires a high school diploma or GED, with a bachelor's degree preferred.No prior experience is required, but 1 year of customer service or hospital/physician office registration experience is preferred.Supervisory Responsibilities: NonePatient Contact: YesAt Dana-Farber Cancer Institute, we work every day to create an innovative, caring, and inclusive environment where every patient, family, and staff member feels they belong.

As relentless as we are in our mission to reduce the burden of cancer for all, we are committed to having faculty and staff who offer multifaceted experiences. Cancer knows no boundaries and when it comes to hiring the most dedicated and compassionate professionals, neither do we. If working in this kind of organization inspires you, we encourage you to apply.Dana-Farber Cancer Institute is an equal opportunity employer and affirms the right of every qualified applicant to receive consideration for employment without regard to race, color, religion, sex, gender identity or expression, national origin, sexual orientation, genetic information, disability, age, ancestry, military service, protected veteran status, or other characteristics protected by law.