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AUTHORIZATIONS REP - JR-15289
Anywhere, USACity of Hope is an independent biomedical research and treatment center for cancer, diabetes and other life-threatening diseases.
Founded in 1913, City of Hope is a leader in bone marrow transplantation and immunotherapy such as CAR T cell therapy. City of Hope’s translational research and personalized treatment protocols advance care throughout the world. Human synthetic insulin, monoclonal antibodies and numerous breakthrough cancer drugs are based on technology developed at the institution. AccessHope™, a wholly owned subsidiary, was launched in 2019 and is dedicated to serving employers and their health care partners by providing access to City of Hope’s exceptional cancer expertise.
A National Cancer Institute-designated comprehensive cancer center and a founding member of the National Comprehensive Cancer Network, City of Hope is ranked among the nation’s “Best Hospitals” in cancer by U.S. News & World Report and received Magnet Recognition from the American Nurses Credentialing Center. Its main campus is located near Los Angeles, with additional locations throughout Southern California and in Arizona.
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.