Remote Authorization Coordinator II

Sutter Health; Modesto (CA); Remote; USD 40,000 - 55,000; Full time

Job summary

Sutter Health is seeking an Eligibility/Authorization specialist to verify patient eligibility, coordinate benefits, and determine if prior authorization is needed for orders. You will obtain authorization when required and document it in the patient EMR, while handling inquiries within established turnaround times.

The role requires HS Diploma or GED and about 1 year of relevant experience, with strong medical terminology knowledge and proficiency in Microsoft Office.

Qualifications

• HS Diploma or GED.
• 1 year recent relevant experience.
• Medical terminology and CPT/HCPCS/ICD-9 coding knowledge.
• Proficiency with Microsoft Office (Excel/Word).
• Strong communication and interpersonal skills.
• Ability to work independently with good judgment.

Responsibilities

• Verify patient eligibility and coordinate benefits and insurance coverage.
• Determine if prior authorization is needed and obtain it for orders; document in EMR.
• Respond to patient inquiries regarding authorizations within turnaround standards.

Skills

Medical terminology

CPT/HCPCS/ICD-9 coding

Anatomy knowledge

Discretion/judgment

Microsoft Excel

Microsoft Word

Active listening

Interpersonal skills

Organizational skills

Education

HS Diploma or GED

Tools

Microsoft Office

Job description

Sutter Health is seeking an Eligibility/Authorization specialist to verify patient eligibility, coordinate benefits, and determine if prior authorization is needed for orders. You will obtain authorization when required and document it in the patient EMR, while handling inquiries within established turnaround times.

The role requires HS Diploma or GED and about 1 year of relevant experience, with strong medical terminology knowledge and proficiency in Microsoft Office.