Authorizations 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:

Overview: The Authorization Representative is responsible for securing insurance authorizations for patients' medical services at City of Hope to ensure reimbursement and minimize patients' financial risk. Focusing on a specific clinical specialty, the representative interacts with payers and clinical staff to obtain authorizations for the modalities within their expertise. Leveraging their knowledge of payer policies and subject matter expertise, the representative routinely influences the approval process by pursuing the necessary documentation to support clinical procedures. The position requires escalating approval issues to clinical staff (primarily physicians) for peer-to-peer reviews with the payer's medical team.

Job Qualifications:

• Must have prior authorization experience

• Subject matter expertise in clinical modalities, including strong knowledge of ICD-9/10 diagnosis codes, CPT codes, and payer policies

• High school diploma or equivalent; associate’s degree preferred

• Minimum of 2 years' experience in a related field, such as medical coding, financial counseling, or similar service profession

• Previous oncology background preferred

• Excellent time management and organizational skills

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

City of Hope employees pay is based on the following criteria:  work experience, qualifications, and work location.