Senior Insurance Specialist – Clinical Trials

🔥 4 hours ago

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City of Hope

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🧬 Biotechnology

🔬 Science

💰 $5.4M Grant - City of Hope on 2024-05

Healthcare • Biotechnology • Science

City of Hope is a nonprofit, NCI-designated comprehensive cancer center and research hospital near Los Angeles that provides patient care, conducts translational biomedical research, and offers education and clinical trials across a national network. It focuses on cancer, diabetes, and other life‑threatening diseases, combining clinical services, laboratory science, training and community outreach to develop new treatments and support patients and families.

📋 Description

• Help oversee daily activities of the Research Insurance Specialist team, including assignments, scheduling coverage, onboarding, training, quality monitoring, coaching, and productivity tracking • Serve as a team resource and liaison when Research Patient Access leadership is unavailable • Participate in workgroups, committees, special projects, and team meetings • Review clinical trial billing grids and budgets to identify standard-of-care procedures and determine insurance authorization needs • Verify hospital and professional insurance benefits through telephone, mail, fax, and online inquiries • Enter and maintain accurate policy benefit, coverage, and authorization information in applicable systems and the medical record • Coordinate with research nurses, case managers, financial counselors, referral teams, registration, clinics, providers, and insurance carriers to obtain timely authorizations and pre-certifications • Request authorization extensions or new authorizations when services or coverage change • Interpret managed care contract summaries, respond to coverage questions, support denial reviews and appeals, and help resolve outstanding account issues • Deliver exceptional service while managing multiple priorities and taking prompt action on high-priority situations • Maintain productivity, accuracy, confidentiality, and compliance with departmental and City of Hope policies, procedures, and standards

🎯 Requirements

• Associate degree, or equivalent experience in place of the minimum education requirement • Five years of related experience, including at least three years of healthcare experience • Strong customer service, communication, organization, problem-solving, and workload-management skills • Ability to work independently with limited supervision and collaboratively within a team environment • Ability to manage competing priorities, work toward measured goals, delegate workload, and remain professional under pressure • Detail-oriented, flexible, persuasive, accountable, and committed to integrity • Proficiency in Microsoft software and a range of PC applications • Bachelor’s degree preferred • Healthcare insurance authorization experience preferred

🏖️ Benefits

• Comprehensive Benefits (details linked in the posting) • Remote work arrangement