- Expertini Resume Scoring: Our Semantic Matching Algorithm evaluates your CV/Résumé before you apply for this job role: Clinical Authorization Specialist OC Support Services Full Time 8 Hour Days (Non Exempt) (Non Union).
Urgent! Clinical Authorization Specialist - OC Support Services - Full Time 8 Hour Days (Non-Exempt) (Non-Union) Job Opening In – Now Hiring University of Southern California
Clinical Authorization Specialist - OC Support Services - Full Time 8 Hour Days (Non-Exempt) (Non-Union)Apply (https://usc.wd5.myworkdayjobs.com/ExternalUSCCareers/job/Newport-Beach-CA/Clinical-Authorization-Specialist----OC-Support-Services---Full-Time-8-Hour-Days--Non-Exempt---Non-Union-_REQ20167030-1/apply) Keck Medicine of USC Hospital Newport Beach, California
The Clinical Authorization Specialist will take the lead in securing medical authorizations from third party payers (commercial and government) for outpatient clinic, inpatient admission, ancillary services and/or chemotherapy and other infused treatments as needed in assigned service line.
The Specialist will be instrumental in obtaining written documentation, submitting tracking, reporting and documenting outcomes of each authorization request.
The Specialist will be in a position to interface directly with medical/clinical staff and pharmacy to ensure a seamless process to the patients receiving treatment.
Essential Duties:
+ Actively obtain written clinical documentation for chemotherapy authorizations in Keckcare for authorization submission from Medical/Nursing Staff
+ Submit pre-certification/pre determination documentation to third party payers/payers insurance carrier for authorization with correct CPT and ICD coding
+ Research payers medical policy requirements for chemotherapy treatment authorizations and understand process for submitting pre-certification/pre- determination requests
+ Utilize Excel Macro tracking log to document authorization requests, follow-up on items and provide outcomes to the Supervisor daily, prior to end of shift.
+ Follow-up on outstanding authorization requests and on medical documentation requests in a timely manner.
+ Enroll patients in manufacturer patient assistance programs as needed and follow-up regarding enrollment and/or medication reimbursements
+ Communicate with a medical/clinical/pharmacy staff and patients on authorization status/outcome.
+ Employ compliance checker for Medicare eligible chemotherapy/infusion treatment authorizations and scan/email ABNS to front area reception for signatures as needed.
+ Coordinate with Director on denied or disputed claims to obtain documentation to support chemotherapy treatment
+ Exhibit sensitivity to the patients at all times concerning privacy and confidentiality while accessing medical records for chemotherapy treatments to process authorizations requests
+ Scan all authorizations into Keck care under the respective patient accounts and if applicable, forward authorized orders to pharmacy for dispensing
+ Maintain medical policy coverage binder and keep updated with new policies and forms regarding medications FDA indicated usage and authorization requirements.
+ Document authorization outcome in all financial systems.
+ Performs other duties as assigned.
Required Qualifications:
+ Req High school or equivalent Or equivalent evidence in file.
+ Req 2 years Experience in a hospital, medical office/doctor’s office or working for a health insurer.
+ Req Excellent time management, organizational skills, research/analytical skills, negotiation, communication (written and verbal), and interpersonal skills
+ Req Able to function independently and as a member of a team.
+ Req Demonstrate excellent customer service behavior.
Preferred Qualifications:
+ Pref Experience in area of service.
+ Pref Medical Prior Authorizations or Claims experience in a managed care setting.
+ Pref Oncology experience.
+ Pref Knowledge of medical terminology.
+ Pref Knowledge of the health insurance industry and claims processing.
Required Licenses/Certifications:
+ Req Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date.
(Required within LA City only)
The hourly rate range for this position is $25.00 - $39.69.
When extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate’s work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.
REQ20167030 Posted Date: 09/04/2025
✨ Smart • Intelligent • Private • Secure
Practice for Any Interview Q&A (AI Enabled)
Predict interview Q&A (AI Supported)
Mock interview trainer (AI Supported)
Ace behavioral interviews (AI Powered)
Record interview questions (Confidential)
Master your interviews
Track your answers (Confidential)
Schedule your applications (Confidential)
Create perfect cover letters (AI Supported)
Analyze your resume (NLP Supported)
ATS compatibility check (AI Supported)
Optimize your applications (AI Supported)
O*NET Supported
O*NET Supported
O*NET Supported
O*NET Supported
O*NET Supported
European Union Recommended
Institution Recommended
Institution Recommended
Researcher Recommended
IT Savvy Recommended
Trades Recommended
O*NET Supported
Artist Recommended
Researchers Recommended
Create your account
Access your account
Create your professional profile
Preview your profile
Your saved opportunities
Reviews you've given
Companies you follow
Discover employers
O*NET Supported
Common questions answered
Help for job seekers
How matching works
Customized job suggestions
Fast application process
Manage alert settings
Understanding alerts
How we match resumes
Professional branding guide
Increase your visibility
Get verified status
Learn about our AI
How ATS ranks you
AI-powered matching
Join thousands of professionals who've advanced their careers with our platform
Unlock Your Clinical Authorization Potential: Insight & Career Growth Guide
Real-time Clinical Authorization Jobs Trends in , United States (Graphical Representation)
Explore profound insights with Expertini's real-time, in-depth analysis, showcased through the graph below. This graph displays the job market trends for Clinical Authorization in , United States using a bar chart to represent the number of jobs available and a trend line to illustrate the trend over time. Specifically, the graph shows 38104 jobs in United States and 0 jobs in . This comprehensive analysis highlights market share and opportunities for professionals in Clinical Authorization roles. These dynamic trends provide a better understanding of the job market landscape in these regions.
Great news! University of Southern California is currently hiring and seeking a Clinical Authorization Specialist OC Support Services Full Time 8 Hour Days (Non Exempt) (Non Union) to join their team. Feel free to download the job details.
Wait no longer! Are you also interested in exploring similar jobs? Search now: Clinical Authorization Specialist OC Support Services Full Time 8 Hour Days (Non Exempt) (Non Union) Jobs .
An organization's rules and standards set how people should be treated in the office and how different situations should be handled. The work culture at University of Southern California adheres to the cultural norms as outlined by Expertini.
The fundamental ethical values are:The average salary range for a Clinical Authorization Specialist OC Support Services Full Time 8 Hour Days (Non Exempt) (Non Union) Jobs United States varies, but the pay scale is rated "Standard" in . Salary levels may vary depending on your industry, experience, and skills. It's essential to research and negotiate effectively. We advise reading the full job specification before proceeding with the application to understand the salary package.
Key qualifications for Clinical Authorization Specialist OC Support Services Full Time 8 Hour Days (Non Exempt) (Non Union) typically include Other General and a list of qualifications and expertise as mentioned in the job specification. Be sure to check the specific job listing for detailed requirements and qualifications.
To improve your chances of getting hired for Clinical Authorization Specialist OC Support Services Full Time 8 Hour Days (Non Exempt) (Non Union), consider enhancing your skills. Check your CV/Résumé Score with our free Resume Scoring Tool. We have an in-built Resume Scoring tool that gives you the matching score for each job based on your CV/Résumé once it is uploaded. This can help you align your CV/Résumé according to the job requirements and enhance your skills if needed.
Here are some tips to help you prepare for and ace your job interview:
Before the Interview:To prepare for your Clinical Authorization Specialist OC Support Services Full Time 8 Hour Days (Non Exempt) (Non Union) interview at University of Southern California, research the company, understand the job requirements, and practice common interview questions.
Highlight your leadership skills, achievements, and strategic thinking abilities. Be prepared to discuss your experience with HR, including your approach to meeting targets as a team player. Additionally, review the University of Southern California's products or services and be prepared to discuss how you can contribute to their success.
By following these tips, you can increase your chances of making a positive impression and landing the job!
Setting up job alerts for Clinical Authorization Specialist OC Support Services Full Time 8 Hour Days (Non Exempt) (Non Union) is easy with United States Jobs Expertini. Simply visit our job alerts page here, enter your preferred job title and location, and choose how often you want to receive notifications. You'll get the latest job openings sent directly to your email for FREE!