Authorizations Specialist

Sacramento-Ear,-Nose-; Sacramento (CA); On-site; USD 42,000 - 54,000; Full time

Job summary

Sacramento Ear, Nose & Throat (SacENT) seeks an Authorization Specialist to manage patient authorization for medical tests and procedures. The role ensures timely and accurate processing to support physicians in delivering high-quality care.

Responsibilities include verifying authorizations for new visits, surgeries, sleep studies, and durable medical equipment; coordinating outside referrals; guiding patients with insurance requirements; and handling retroactive authorizations as needed.

Qualifications

• High school diploma or GED required.
• Minimum 2 years of authorization experience in medical/hospital setting.
• EPIC EHR experience preferred.

Responsibilities

• Obtains and verifies authorization for new and return patient visits.
• Obtains and verifies authorizations for surgical procedures.
• Requests authorization for Sleep Studies and durable medical equipment.
• Handles Outside Referrals to other facilities.
• Refer patients back to PCP's office when insurance dictates.
• Obtains retroactive authorization when needed.
• Other duties as assigned.

Skills

Interpersonal skills

Critical thinking

Prioritization

Organization

Education

High School diploma or GED

Tools

EPIC EHR

Job description

Originally established in 1957, Sacramento Ear, Nose & Throat’s (SacENT) award-winning physicians are nationally recognized leaders in their fields. At SacENT, the mission of the physicians and staff is to provide the highest standard of state-of-the-art specialty medical care in a personal, compassionate manner.

POSITION SUMMARY

The Authorizations Specialist is responsible for obtaining authorization as required for medical tests and/or surgical procedures as ordered by Sacramento ENT physicians.

ESSENTIAL FUNCTIONS

• Obtains and verifies authorization for new and return patient visits.
• Obtains and verifies authorizations for surgical procedures.
• Request authorization for Sleep Studies and durable medical equipment deemed necessary for follow-up patient care.
• Outside Referrals to other facilities.
• Refer patients back to PCP’s office if insurance dictates patient needs to be referred elsewhere.
• Obtains retroactive authorization when needed.
• Other duties as assigned.

KNOWLEDGE, SKILLS AND EXPERIENCE

• High School degree or GED

Minimum Experience required:

• Minimum of 2 years authorizations’ experience in a medical or hospital setting.
• EPIC EHR experience preferred

Skills/Knowledge/Ability:

• Interpersonal: Above average communication skills. Professional attitude and ability to establish and maintain effective relationships with staff, patients and public.
• Critical thinking: Ability to assess, prioritize, plan and implement tasks effectively. Ability to read, understand and follow oral and written instructions.
• Knowledge: Demonstrates knowledge of authorization procedures from running reports to obtaining authorization via phone or internet. Knowledgeable in reading and understanding reports to facilitate authorizations process. Knowledgeable in the use of medical management software to enter all necessary information on authorization status.