Authorizations Coordinator I (Hybrid) - 26-109

PriMed Management Consulting Services, Inc.; Swanston (CA); Hybrid; USD 55,000 - 60,000; Full time

Job summary

Hill Physicians Medical Group in Sacramento, CA is seeking a Health Care Authorization Specialist to coordinate the authorization process and support the HRM department. This hybrid role requires accuracy in data entry and knowledge of medical terminology, CPT/ICD10 codes, and Epic systems.

You will handle phone inquiries, monitor CSR activity, and collaborate with multiple departments to ensure timely decisions and excellent member service.

Qualifications

• Medical Assistant certification or 1–3 years healthcare experience preferred.
• Strong knowledge of CPT/ICD10 & HCPCS codes.
• Accurate data entry and Microsoft Office skills (intermediate).
• Strong verbal communication, decision-making and problem solving skills.

Responsibilities

• Coordinate the authorization process per HRM procedures and policy.
• Enter authorization data into Epic database using correct types and codes.
• Answer phone queue line calls per departmental standards.
• Monitor CSR activity and respond within department standards.
• Serve as a resource for customer service.

Skills

Medical terminology

Strong communication

Attention to detail

Multi-tasking

Independent & team

Education

H.S. Diploma or GED

Tools

Epic/Tapestry

MS Office

CPT/ICD10 & HCPCS

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:Coordinate the authorization process and support the Health Resources Management Department (HRM).Job ResponsibilitiesComplete 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 ResponsibilitiesServe as resource for customer service.Maintain open lines of communication within all departments of the organization.Required ExperienceMedical Assistant certification and/or 1-3 years of Healthcare experience preferredStrong knowledge of medical terminologyWorking knowledge of CPT/ICD10 & HCPCS codesAccurate data entry and Microsoft Office skills (intermediate).Strong verbal communication, decision-making and problem solving skillsStrong organizational skills and detail orientedAbility to work independently and as part of a teamAble to multi-task and work in a productivity-based environmentEpic/Tapestry experience is a plusRequired EducationH.S. Diploma or GEDAdditional InformationLocation: Sacramento (Hybrid)Salary: $26.50 - $29 hourlyHill Physicians is an Equal Opportunity Employer