Utilization Management Lead — Authorization & CSR Support

PriMed Management Consulting Services, Inc.; Sacramento (CA); On-site; USD 108,000 - 138,000; Full time

Job summary

Hill Physicians Medical Group is seeking a Detail-Oriented Authorization Support Specialist to coordinate the authorization process and support the Health Resources Management Department (HRM) in Sacramento. You will review requests, apply benefits criteria, and ensure timely decisions.

This role requires medical terminology knowledge, CPT/ICD-10 & HCPCS familiarity, accurate data entry into Epic, and strong communication with members and providers.

Qualifications

• 1–3 years of healthcare experience preferred.
• Medical terminology knowledge required.
• Familiar with CPT/ICD-10 & HCPCS codes.
• Accurate data entry with intermediate Microsoft Office.
• Strong verbal communication and problem solving.
• Organizational skills and detail oriented.
• Ability to work independently and as part of a team.
• Ability to multitask in a productivity-based environment.

Responsibilities

• Complete authorization requests per HRM procedures.
• Research and troubleshoot complex rules to render correct decisions.
• Enter authorization data into Epic using correct types and codes.
• Answer phone queue in accordance with departmental standards.
• Monitor CSR activity and respond within standards.
• Serve as a resource for customer service.
• Maintain open communication across departments.

Skills

Medical terminology

Data entry

Microsoft Office

Verbal communication

Organizational skills

Teamwork

Multi-tasking

Independent work

Education

High School Diploma or GED

Tools

Epic/Tapestry

Job description

Hill Physicians Medical Group is seeking a Detail-Oriented Authorization Support Specialist to coordinate the authorization process and support the Health Resources Management Department (HRM) in Sacramento. You will review requests, apply benefits criteria, and ensure timely decisions.

This role requires medical terminology knowledge, CPT/ICD-10 & HCPCS familiarity, accurate data entry into Epic, and strong communication with members and providers.