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Procedure Authorization Coordinator

2 months ago

Cerritos, United States The Oncology Institute of Hope and Innovation Full time
Job DescriptionJob Description

Founded in 2007, The Oncology Institute of Hope and Innovation (TOI) is advancing oncology by delivering highly specialized, value-based cancer care in the community setting. TOI is dedicated to offering cutting edge, evidence-based cancer care to a population of more than 1.7 million patients including clinical trials, stem cell transplants, transfusions, and other care delivery models traditionally associated with the most advanced care delivery organizations. With 100+ employed clinicians and more than 700 teammates in 75+ clinic locations and growing. TOI is changing oncology for the better.

Job Duties:

Coordinate with third-party insurance, clinical staff, and patients to effectively process prior authorization requests for all Visits and Exams Scheduled including Blood Transfusions. Compile clinical documentation for prior authorizations (ex: progress notes, labs, diagnoses codes, previously tried therapies, doctor visits). This position is full-time, Monday-Friday, in our Cerritos, California Headquarters.

  • Scheduling
  • Review authorization queue for applicable orders
  • Verify and comply with payer contractual authorization requirements
  • Submit authorization request timely and efficiently, ensuring proper documentation is included for review
  • Utilize website portal, and electronic options to submit authorization requests
  • Work with management to identify payer trends or potential issues
  • Demonstrate exceptional customer service skills in the performance of work assignments and duties
  • Perform special projects or other duties as assigned
  • Maintains confidentiality of patient records

Skills & Abilities:

  • Self-motivation and ability to work effectively in an independent environment
  • Arrives promptly and completes shifts as needed to meet demands of daily prior authorization and/or financial assistance requests
  • Reliable, dependable, accountable, punctual
  • Attention to detail
  • Ability to learn new things quickly
  • Possesses a strong organizational and task prioritization skillset
  • Proficient in Microsoft Office particularly Excel, Word, and Outlook
  • Work well under deadlines and time pressures
  • Results-oriented with a positive outlook, and a clear focus on high quality

Experience/ Education

Required:

  • High school diploma or GED

Preferred:

  • Experience performing prior authorizations or processing patient financial assistance
  • Experience using EMR systems
  • Administrative experience in a physician office, clinic, hospital, or health insurance
  • CPT and ICD10 Knowledge
  • Medical Terminology
  • Insurance knowledge; PPO, HMO, Medi-Cal, Medicare, Workers Compensation
  • Bilingual in Spanish and English

The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role.

Pay Transparency for hourly teammates$18—$21 USD