Authorization Coordinator II

Sutter Health; Sacramento (CA); On-site; USD 40,000 - 55,000; Full time

Benefits offered by this job

Benefits

Job summary

Sutter Health is seeking a detail-oriented specialist to verify patient eligibility and coordinate benefits. The role ensures insurance coverage and determines if prior authorization is needed for orders. If required, authorization is obtained and documented in the patient EMR.

You will respond to patient inquiries regarding authorizations within turnaround standards, using medical terminology and accurate coding knowledge to support clinical workflows.

Qualifications

• HS Diploma or GED required.
• 1 year of recent relevant experience.
• Knowledge of CPT/HCPCS/ICD-9 coding.
• Strong medical terminology knowledge.
• Proficiency with Microsoft Office (Excel/Word).
• Ability to exercise discretion and independent judgment.
• Attention to detail and good communication.

Responsibilities

• Verify patient eligibility and coordinate benefits.
• Determine if prior authorization is needed for orders.
• Obtain authorization and document in the EMR.
• Respond to patient inquiries regarding authorizations within turnaround standards.

Skills

Medical terminology

CPT/HCPCS/ICD-9 coding

Anatomy knowledge

Discretion and independent judgment

Microsoft Office (Excel/Word)

Active listening

Organizational skills

Education

HS Diploma or GED

Job description

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

Organization

SHSO-Sutter Health System Office-Valley

Position Overview

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.

Job Description

• 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

None

Benefits

Yes

Unions

No

Position Status

Non-Exempt

Weekly Hours

40

Employee Status

Limited Term (Fixed Term)

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.