Authorization Coordinator II

Sutter Health•Santa Barbara, CA

About The Position

The Authorization Coordinator II is responsible for verifying patient eligibility, coordinating benefits, ensuring insurance coverage, and determining if prior authorization is required for medical orders. If authorization is needed, the coordinator obtains it and documents the process in the patient's electronic medical record. This role also involves responding to patient inquiries regarding authorizations within established turnaround standards.

Requirements

HS Diploma or GED
1 year recent relevant experience
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

Responsibilities

Perform the appropriate processes to verify patient eligibility
Coordinate benefits
Ensure insurance coverage
Determine if prior authorization is needed for said order
Obtain authorization (if needed)
Document authorization in the patient electronic medical record
Facilitate responses to patient inquiries regarding authorizations within turnaround standards