Authorization Coordinator II

Sutter Health•Modesto, CA

3d•Remote

About The Position

This position is eligible to work from home within the Sutter Health Northern California footprint. The Authorization Coordinator II performs processes to verify patient eligibility, coordinate benefits, ensure insurance coverage, and determine whether prior authorization is needed for an order. When authorization is needed, the coordinator obtains it and documents it in the patient electronic medical record. The role also facilitates responses to patient inquiries regarding authorizations within turnaround standards.

Requirements

High school diploma or GED.
One year of recent relevant experience.
Knowledge of medical terminology and anatomy.
Knowledge of CPT, HCPCS, and ICD-9 coding.
Ability to exercise discretion and make independent judgments, seeking review when decisions significantly depart from established guidelines.
Knowledge of Microsoft Office programs, including Excel and Word, or similar programs.
Ability to maintain composure during challenging interpersonal interactions.
Active listening, interpersonal, and telephone communication skills.
Organizational skills, attention to detail, and follow-up.

Responsibilities

Verify patient eligibility.
Coordinate benefits and ensure insurance coverage.
Determine whether prior authorization is needed for an order.
Obtain needed authorizations and document them in the patient electronic medical record.
Facilitate responses to patient inquiries regarding authorizations within turnaround standards.