Authorizations Coordinator I (Hybrid) - 26-109

primed; Sacramento (CA); Hybrid; USD 37,000 - 40,000; Full time

Benefits offered by this job

Hybrid work arrangement

Job summary

Hill Physicians Medical Group in Sacramento (Hybrid) is seeking a Medical Authorization Specialist to support complex authorization decisions. You will complete authorization requests, research rules, and enter data into the Epic system while providing reliable customer service.

Ideal candidates have a Medical Assistant certification or 1–3 years of healthcare experience, and knowledge of CPT/ICD10 & HCPCS codes plus strong MS Office skills.

Qualifications

• H.S. Diploma or GED required.
• Medical terminology knowledge preferred.
• CPT/ICD10 & HCPCS knowledge preferred.
• Strong data entry and MS Office skills.
• Excellent verbal communication and problem-solving abilities.

Responsibilities

• Complete authorization requests per HRM procedures.
• Research and troubleshoot authorization rules based on benefits and contracts.
• Enter authorization data into Epic using correct types and codes.
• Answer phone queue calls per departmental standards.
• Monitor CSR activity and respond within standards.
• Serve as a resource for customer service.
• Maintain open communication across departments.

Skills

Medical terminology

Healthcare experience

Verbal communication

Problem solving

Organization

Detail oriented

Teamwork

Data entry

CPT/ICD10 knowledge

Education

High School Diploma or GED

Tools

Epic/Tapestry

Microsoft Office

Job description

We're delighted you're considering joining us!
At Hill Physicians Medical Group, we're shaping the healthcare of the future: actively managed care that prevents disease, supports those with chronic conditions and anticipates the needs of our members.

Join Our Team!

Hill Physicians has much to offer prospective employees. We're regularly recognized as one of the "Best Places to Work in the Bay Area" and have been recognized as one of the "Healthiest Places to Work in the Bay Area." When you join our team, you're making a great choice for your professional career and your personal satisfaction.

DE&I Statement:

At PriMed, your uniqueness is valued, celebrated, encouraged, supported, and embraced. Whatever your relationship with Hill Physicians, we welcome ALL that you are.

We value and respect your race, ethnicity, gender identity, sexual orientation, age, religion, disabilities, experiences, perspectives, and other attributes. Our celebration of diversity and foundation of inclusion allows us to leverage our differences and capitalize on our similarities to better serve our communities. We do it because it's right!

Job Description:

Job Responsibilities

• Complete authorization requests in accordance to the operational procedures outlined within the HRM Operations Manual and Policy Provisions. This includes:
• Researching and troubleshooting complex authorization rules to render the correct decision based on members' benefits, a Health Plans' contractual arrangements, and specific criteria to determine if service may be authorized.
• Enter authorization data into Epic database using correct types and codes.
• Answer phone queue line calls in accordance with departmental standards.
• Monitor Customer Service Requests (CSR) activity; respond appropriately within department standards.

Additional Responsibilities

• Serve as resource for customer service.
• Maintain open lines of communication within all departments of the organization.

Required Experience

• Medical Assistant certification and/or 1-3 years of Healthcare experience preferred
• Strong knowledge of medical terminology
• Working knowledge of CPT/ICD10 & HCPCS codes
• Accurate data entry and Microsoft Office skills (intermediate).
• Strong verbal communication, decision-making and problem solving skills
• Strong organizational skills and detail oriented
• Ability to work independently and as part of a team
• Able to multi-task and work in a productivity-based environment
• Epic/Tapestry experience is a plus

Required Education

• H.S. Diploma or GED

Additional Information

• Location: Sacramento (Hybrid)
• Salary: $26.50 - $29 hourly

Hill Physicians is an Equal Opportunity Employer