Authorization Coordinator II

Sutter Health; Modesto (CA); Remoto; USD 40.000 - 55.000; Tempo pieno

Descrizione del lavoro

Sutter Health is seeking an Eligibility/Authorization specialist to verify patient eligibility, coordinate benefits, and determine if prior authorization is needed for orders. You will obtain authorization when required and document it in the patient EMR, while handling inquiries within established turnaround times.

The role requires HS Diploma or GED and about 1 year of relevant experience, with strong medical terminology knowledge and proficiency in Microsoft Office.

Competenze

• HS Diploma or GED.
• 1 year recent relevant experience.
• Medical terminology and CPT/HCPCS/ICD-9 coding knowledge.
• Proficiency with Microsoft Office (Excel/Word).
• Strong communication and interpersonal skills.
• Ability to work independently with good judgment.

Mansioni

• Verify patient eligibility and coordinate benefits and insurance coverage.
• Determine if prior authorization is needed and obtain it for orders; document in EMR.
• Respond to patient inquiries regarding authorizations within turnaround standards.

Conoscenze

Medical terminology

CPT/HCPCS/ICD-9 coding

Anatomy knowledge

Discretion/judgment

Microsoft Excel

Microsoft Word

Active listening

Interpersonal skills

Organizational skills

Formazione

HS Diploma or GED

Strumenti

Microsoft Office

Descrizione del lavoro

We are so glad you are interested in joining Sutter Health!

Organization

SHSO-Sutter Health System Office-Valley

Position Overview

• This position is eligible to work from home within the Sutter Health Northern California footprint.

Responsible for performing the appropriate processes to verify patient eligibility, coordinate benefits, ensure insurance coverage, and determine if prior authorization is needed for said order. If needed, obtains authorization and documents in the patient electronic medical record. Facilitates responses to patient inquiries regarding authorizations within turnaround standards.

Education

• HS Diploma or GED

Typical Experience

• 1 year recent relevant experience.

Skills And Knowledge

• Medical terminology, Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS)/International Classification of Diseases (ICD)-9 coding knowledge.
• Knowledge of medical terminology/anatomy.
• Ability to exercise discretion and make independent judgments, seeking review when decisions represent significant departure from established guidelines.
• Knowledge of Microsoft Office programs including Excel, Word or similar programs.
• Ability to maintain composure during challenging interpersonal interactions.
• Active listening skills; including interpersonal skills and telephone communication.
• Organizational skills with attention to detail and follow-up.

Job Shift

Days

Schedule

Full Time

Shift Hours

8

Days Of The Week

Monday - Friday

Weekend Requirements

As Needed

Benefits

Yes

Unions

No

Position Status

Non-Exempt

Weekly Hours

40

Employee Status

Regular

Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.

Pay Range is $28.75 to $40.24 / hour

The posted pay range is based on the position's primary work location. Candidates who reside and work outside of that location may be subject to a different pay range based on their work location. Candidate starting salaries consider multiple factors, including, but not limited to a candidate’s experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is only one component of Sutter Health’s comprehensive total rewards program. Eligible positions also include a comprehensive benefits package.