Authorization Coordinator III, Rheumatology

Sutter Health; San Francisco (CA); On-site; USD 46,000 - 65,000; Full time

Job summary

Sutter Health in San Francisco is seeking a Medical Administrative Specialist to support providers by obtaining referrals and prior authorizations for specialty care.

In a Managed Care environment, you will process authorization requests, coordinate with health plans, and assist Case Management, serving as a primary resource on the authorization process for providers.

Qualifications

• HS Diploma or GED required.
• 2 years recent relevant experience.
• Knowledge of medical terminology and coding systems.

Responsibilities

• Provides medical administration support to providers by obtaining referrals or prior authorizations for patients to see specialty providers.
• Completes referrals and/or authorizations accurately and consistently with minimal supervision.
• Processes authorization and referral requests in Managed Care in coordination with health plans and contracted providers.
• Provides support to the Case Management staff.
• Serves as a resource to providers regarding the authorization process.

Skills

Medical terminology

CPT/HCPCS/ICD-9 coding

Microsoft Office

Interpersonal skills

Active listening

Telephone communication

Attention to detail

Discretion/Judgement

Education

HS Diploma or GED

Job description

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

Organization:

SPMF-Sutter Pacific Medical Foundation - South

Position Overview:

Provides medical administration support to providers by obtaining referral or prior authorizations for patients to see specialty providers. Completes referrals and/or authorizations accurately and consistently with minimal supervision. In Managed Care, processes authorization and referral requests for members in coordination with health plans and contracted providers. Provides support to the Case Management staff. Serves as a resource to providers regarding the authorization process.

Job Description :

EDUCATION:

• HS Diploma or GED

TYPICAL EXPERIENCE:

• 2 years 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 judgements, 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 $33.45 to $46.83 / 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.