Coordinator, Medical Staff - Full Time

Sutter Health; California; Remote; USD 40,000 - 55,000; Full time

Benefits offered by this job

Benefits package

Job summary

Sutter Health is seeking a Healthcare Eligibility Specialist to work remotely within the Northern California footprint. The role entails verifying patient eligibility, coordinating benefits, determining need for prior authorization, and documenting in the EMR.

You will respond to patient inquiries within established turnaround standards and maintain compliance with guidelines. Requires a HS Diploma or GED and at least 1 year of relevant experience, with strong medical terminology knowledge and

Qualifications

• HS Diploma or GED required.
• 1 year of recent relevant experience.
• Knowledge of medical terminology and coding systems (CPT/HCPCS/ICD-9).
• Ability to exercise discretion and independent judgment.
• Proficiency with Microsoft Office (Excel, Word).
• Strong communication and organizational skills.
• Active listening and interpersonal abilities.

Responsibilities

• Verify patient eligibility and coordinate benefits.
• Determine if prior authorization is needed and obtain authorization.
• Document authorization in the EMR.
• Respond to patient inquiries regarding authorizations within turnaround standards.
• Maintain accuracy and adherence to established guidelines.

Skills

Medical terminology

CPT/HCPCS/ICD-9 coding

Anatomy knowledge

Discretion and independent judgment

MS Office (Excel/Word)

Interpersonal communication

Active listening

Organizational skills

Telephone communication

Education

HS Diploma or GED

Tools

Microsoft Office

Excel

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.

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 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 / 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.