The Oncology Institute
Prior Authorization Coordinator Chemotherapy
The Oncology Institute, Cerritos, California, United States, 90703
Prior Authorization Coordinator Chemotherapy
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Prior Authorization Coordinator Chemotherapy
role at
The Oncology Institute .
About The Oncology Institute Founded in 2007, The Oncology Institute (NASDAQ: TOI) is advancing oncology by delivering highly specialized, value‑based cancer care in the community setting. TOI offers cutting‑edge, evidence‑based care to a population of approximately 1.9 million patients, including clinical trials, transfusions, and other care delivery models traditionally associated with the most advanced care delivery organizations. With over 180 employed and affiliate clinicians and over 100 clinics and affiliate locations across five states and growing, TOI is changing oncology for the better.
At The Oncology Institute of Hope and Innovation, every decision you make in chemotherapy authorizations directly impacts patient care. Your expertise ensures that patients receive timely, medically appropriate treatments while advancing our mission to deliver compassionate, state‑of‑the‑art oncology care.
Job Duties
Coordinate with third‑party insurance, clinical staff, and patients to effectively process prior authorization requests for Chemotherapy (IV and Oral), Hydration, and IV injections. Compile clinical documentation for prior authorizations (e.g., progress notes, labs, diagnoses codes, previously tried therapies, doctor visits). This is one of the most important roles within the organization that allows our patients to receive timely care and TOI’s appropriate reimbursement.
Review authorization queue for applicable orders.
Verify and comply with payer contractual authorization requirements.
Submit authorization requests timely and efficiently, ensuring proper documentation is included for review.
Utilize website portal and electronic options to submit authorization requests.
Submit verbal prescription orders approved by Provider and Medical Director to pharmacies, in conjunction with printed copy.
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.
Maintain confidentiality of patient records.
Experience / Education
Self‑motivation and ability to work effectively in an independent environment.
Comfortable working with patients who have cancer or a blood disorder.
Experience on the payer side reviewing chemo authorizations submitted by the provider.
Attention to detail.
Ability to learn new things quickly.
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 focus on high quality.
High school diploma or GED.
Experience performing, reviewing, or generating prior authorizations for procedures or chemotherapy specifically is preferred.
Administrative experience in a physician office, clinic, hospital, or health insurance/payer is a plus.
CPT and ICD10 knowledge.
Medical terminology.
Insurance knowledge; PPO, HMO, Medi‑Cal, Medicare, Workers Compensation.
Pay Transparency for hourly teammates $21—$22.25 USD
Pay Transparency for salaried teammates $21—$22.25 USD
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Prior Authorization Coordinator Chemotherapy
role at
The Oncology Institute .
About The Oncology Institute Founded in 2007, The Oncology Institute (NASDAQ: TOI) is advancing oncology by delivering highly specialized, value‑based cancer care in the community setting. TOI offers cutting‑edge, evidence‑based care to a population of approximately 1.9 million patients, including clinical trials, transfusions, and other care delivery models traditionally associated with the most advanced care delivery organizations. With over 180 employed and affiliate clinicians and over 100 clinics and affiliate locations across five states and growing, TOI is changing oncology for the better.
At The Oncology Institute of Hope and Innovation, every decision you make in chemotherapy authorizations directly impacts patient care. Your expertise ensures that patients receive timely, medically appropriate treatments while advancing our mission to deliver compassionate, state‑of‑the‑art oncology care.
Job Duties
Coordinate with third‑party insurance, clinical staff, and patients to effectively process prior authorization requests for Chemotherapy (IV and Oral), Hydration, and IV injections. Compile clinical documentation for prior authorizations (e.g., progress notes, labs, diagnoses codes, previously tried therapies, doctor visits). This is one of the most important roles within the organization that allows our patients to receive timely care and TOI’s appropriate reimbursement.
Review authorization queue for applicable orders.
Verify and comply with payer contractual authorization requirements.
Submit authorization requests timely and efficiently, ensuring proper documentation is included for review.
Utilize website portal and electronic options to submit authorization requests.
Submit verbal prescription orders approved by Provider and Medical Director to pharmacies, in conjunction with printed copy.
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.
Maintain confidentiality of patient records.
Experience / Education
Self‑motivation and ability to work effectively in an independent environment.
Comfortable working with patients who have cancer or a blood disorder.
Experience on the payer side reviewing chemo authorizations submitted by the provider.
Attention to detail.
Ability to learn new things quickly.
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 focus on high quality.
High school diploma or GED.
Experience performing, reviewing, or generating prior authorizations for procedures or chemotherapy specifically is preferred.
Administrative experience in a physician office, clinic, hospital, or health insurance/payer is a plus.
CPT and ICD10 knowledge.
Medical terminology.
Insurance knowledge; PPO, HMO, Medi‑Cal, Medicare, Workers Compensation.
Pay Transparency for hourly teammates $21—$22.25 USD
Pay Transparency for salaried teammates $21—$22.25 USD
#J-18808-Ljbffr