Authorization Coordinator II
Sutter Health•Sacramento, CA
•Onsite
About The Position
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.
Requirements
- HS Diploma or GED
- 1 year recent relevant experience
- Medical terminology knowledge
- 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
- Interpersonal skills
- Telephone communication skills
- Organizational skills with attention to detail and follow-up
Responsibilities
- Verify patient eligibility
- Coordinate benefits
- Ensure insurance coverage
- Determine if prior authorization is needed for an order
- Obtain prior authorization if needed
- Document authorizations in the patient electronic medical record
- Respond to patient inquiries regarding authorizations within turnaround standards
Benefits
- Comprehensive benefits package
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
