Healthcare Authorization Specialist II

Sutter Health; Sacramento (CA); On-site; USD 40,000 - 55,000; Full time

Benefits offered by this job

Benefits

Job summary

Sutter Health is seeking a detail-oriented specialist to verify patient eligibility and coordinate benefits. The role ensures insurance coverage and determines if prior authorization is needed for orders. If required, authorization is obtained and documented in the patient EMR.

You will respond to patient inquiries regarding authorizations within turnaround standards, using medical terminology and accurate coding knowledge to support clinical workflows.

Qualifications

• HS Diploma or GED required.
• 1 year of recent relevant experience.
• Knowledge of CPT/HCPCS/ICD-9 coding.
• Strong medical terminology knowledge.
• Proficiency with Microsoft Office (Excel/Word).
• Ability to exercise discretion and independent judgment.
• Attention to detail and good communication.

Responsibilities

• Verify patient eligibility and coordinate benefits.
• Determine if prior authorization is needed for orders.
• Obtain authorization and document in the EMR.
• Respond to patient inquiries regarding authorizations within turnaround standards.

Skills

Medical terminology

CPT/HCPCS/ICD-9 coding

Anatomy knowledge

Discretion and independent judgment

Microsoft Office (Excel/Word)

Active listening

Organizational skills

Education

HS Diploma or GED

Job description

Sutter Health is seeking a detail-oriented specialist to verify patient eligibility and coordinate benefits. The role ensures insurance coverage and determines if prior authorization is needed for orders. If required, authorization is obtained and documented in the patient EMR.

You will respond to patient inquiries regarding authorizations within turnaround standards, using medical terminology and accurate coding knowledge to support clinical workflows.