Authorization Coordinator II

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

Job summary

Sutter Health is seeking a Claims Eligibility Specialist to work from home within the Northern California footprint. You will verify patient eligibility, coordinate benefits, and determine if prior authorization is required for orders, obtaining authorizations when needed and documenting in the electronic medical record.

You will respond to patient inquiries regarding authorizations within established turnaround times, demonstrate strong medical terminology knowledge, and use Microsoft Office

Qualifications

• HS Diploma or GED required.
• 1 year recent relevant experience.
• Knowledge of CPT/HCPCS/ICD-9 coding.
• Knowledge of medical terminology/anatomy.
• Strong organizational and communication skills.

Responsibilities

• Verify patient eligibility and coordinate benefits.
• Determine if prior authorization is needed and obtain authorization.
• Document authorization in the patient electronic medical record.
• Respond to inquiries regarding authorizations within turnaround standards.

Skills

Medical terminology

Anatomy knowledge

Discretion

Microsoft Office

Active listening

Interpersonal skills

Telephone communication

Attention to detail

Organization

Education

HS Diploma or GED

Tools

Microsoft Office

Job description

We are so glad you are interested in joining Sutter Health! Organization: SHSO-Sutter Health System Office-Valley

Position Overview: This position is available to work from home from 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.

Job Description

• EDUCATION:HS Diploma or GED
• TYPICAL EXPERIENCE:1 year recent relevant experience.

• 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 / hourThe 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.