Oncology Authorization Specialist – Ambulatory Care

Keck Medicine of USC; Los Angeles (CA); On-site; USD 36,000 - 57,000; Full time

Job summary

Keck Medicine of USC is seeking a Clinical Authorization Specialist in Los Angeles, CA. The role leads in securing medical authorizations from third-party payers for outpatient clinic, chemotherapy, and related services, coordinating with medical staff and pharmacy to ensure a smooth patient experience.

The Specialist reports to the Administrative Clinic Manager and supports Koreatown Buena Park Medical Oncology/ Multi-Disciplinary Clinic with documentation, tracking, and outcomes reporting.

Qualifications

• High school or equivalent required.
• 2 years experience in hospital/medical setting or health insurer preferred.
• Excellent time management and organizational skills.
• Strong communication and customer service abilities.

Responsibilities

• Actively obtain written clinical documentation for ambulatory clinic services for authorization submission.
• Submit pre-certification/pre-determination documentation with correct CPT/ICD coding.
• Research payer medical policy requirements for authorizations.
• Use Excel to track authorization requests and report outcomes to supervisor.
• Follow-up on outstanding authorizations and document outcomes.
• Enroll patients in manufacturer patient assistance programs as needed.

Skills

Time management

Organizational skills

Research/analytical skills

Negotiation

Communication

Interpersonal skills

Customer service

Education

High school or equivalent

Job description

Keck Medicine of USC is seeking a Clinical Authorization Specialist in Los Angeles, CA. The role leads in securing medical authorizations from third-party payers for outpatient clinic, chemotherapy, and related services, coordinating with medical staff and pharmacy to ensure a smooth patient experience.

The Specialist reports to the Administrative Clinic Manager and supports Koreatown Buena Park Medical Oncology/ Multi-Disciplinary Clinic with documentation, tracking, and outcomes reporting.