Authorization Coordinator II

Sutter Health; Sacramento (CA); In loco; USD 40.000 - 55.000; Tempo pieno

Descrizione del lavoro

Sutter Health is seeking an Eligibility and Authorization Specialist to verify patient eligibility, coordinate benefits, and determine prior authorization needs. The role requires documenting authorizations in the EMR and responding to patient inquiries within set turnaround standards.

Ideal candidates have a HS Diploma or GED and at least 1 year of related experience, with strong medical terminology knowledge and proficiency in Microsoft Office.

Competenze

• HS Diploma or GED required.
• 1 year of recent relevant experience required.
• Knowledge of medical terminology and coding systems preferred.

Mansioni

• Verify patient eligibility and coordinate benefits.
• Determine if prior authorization is needed and obtain it.
• Ensure insurance coverage is verified and documented in the EMR.
• Respond to patient inquiries regarding authorizations within turnaround standards.

Conoscenze

Medical terminology

CPT/HCPCS/ICD-9 coding

Anatomy knowledge

Discretion/judgment

MS Office

Active listening

Interpersonal communication

Organizational skills

Formazione

HS Diploma or GED

Strumenti

Microsoft Excel

Microsoft Word

Descrizione del lavoro

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.

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

None

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.