Authorization Rep

About City of Hope,
City of Hope's mission is to make hope a reality for all touched by cancer and diabetes. Founded in 1913, City of Hope has grown into one of the largest and most advanced cancer research and treatment organizations in the U.S., and one of the leading research centers for diabetes and other life-threatening illnesses. City of Hope research has been the basis for numerous breakthrough cancer medicines, as well as human synthetic insulin and monoclonal antibodies. With an independent, National Cancer Institute-designated comprehensive cancer center that is ranked top 5 in the nation for cancer care by U.S. News & World Report at its core, City of Hope’s uniquely integrated model spans cancer care, research and development, academics and training, and a broad philanthropy program that powers its work. City of Hope’s growing national system includes its Los Angeles campus, a network of clinical care locations across Southern California, a new cancer center in Orange County, California, and cancer treatment centers and outpatient facilities in the Atlanta, Chicago and Phoenix areas.

The successful candidate:

This position is responsible for the authorizations for medical services at City of Hope.  This role will obtain accurate and timely decisions from payers regarding authorizations of chemotherapy/oncology services. Candidate may be crossed trained in the following modalities, medical procedures, high tech imaging services, surgical cases, personalized genomic medicine, technically advanced radiation therapy treatments, and any other procedure requiring authorization.  This position requires excellent time management and organizational skills as well as the ability to provide clear and concise communicated both verbally and written. This position is empowered to approve, pend or deny services for our population of patients according to policy. This position requires strong knowledge of ICD9/10 diagnosis codes as well as CPT codes

Minimum Job Qualifications

Education: High school diploma/equivalent

Experience: Must have minimum of 2 years’ experience in this field or related field such as medical coding, financial counseling setting or similar service profession

Knowledge, Skills, Abilities:

• Solid knowledge of medical terminology, ICD9 codes, CPT/HCPC’s codes.

• Advanced written and verbal communication skills.

• Excellent organizational skills, ability to manage multiple priorities and responsibilities.

• Outstanding communication and customer service skills.

• Ability to utilize critical thinking and apply sound judgment and assessment skills for decision-making.

• Candidate must be proficient using a computer, using online websites and email Demonstrates the willingness to research, learn and to obtain knowledge for the performance of the position. Ability to utilize multiple systems within the organization as well as outside such as insurance authorization portals. 

• Ability to prioritize work assignments for efficiency and to meet timeframes for precertification. Must independently perform follow up of pending precertification's and communicate potential delays appropriately.

Preferred Attributes

• Previous oncology background preferred

City of Hope is an equal opportunity employer. To learn more about our commitment to diversity, equity, and inclusion, please click here.

To learn more about our comprehensive benefits, click here: Benefits Information