Procedure Authorization Coordinator Bilingual

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


• Bilingual in English and Spanish

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