Founded in 2007, The Oncology Institute of Hope and Innovation (TOI) is the largest community oncology practice on the west coast, and the nation’s leading value-based oncology services platform. TOI employs 75 physicians and mid-levels in 39 clinic locations, with over 500 total employees helping to deliver cutting edge, evidence-based cancer care to a population of over 1 million patients. TOI is headquartered in Cerritos, CA, and serves patients throughout California, Arizona, and Nevada.
TOI brings comprehensive, integrated cancer care into community settings, offering patients modern infusion centers, chemotherapy educational sessions, in-house support groups, dietary and nutritional counselling, in-house pharmacy, financial counseling, comprehensive lab testing, advanced care planning, and end-of-life counseling.
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)
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
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
Experience using EMR systems
Highly 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.
High school diploma or GED
Experience performing prior authorizations or patient financial assistance is preferred
Administrative experience in a physician office, clinic, hospital, or health insurance is a plus