Authorization Coordinator III, Rheumatology

Sutter Health•San Francisco, CA

15d

About The Position

Provides medical administration support to providers by obtaining referral or prior authorizations for patients to see specialty providers. Completes referrals and/or authorizations accurately and consistently with minimal supervision. In Managed Care, processes authorization and referral requests for members in coordination with health plans and contracted providers. Provides support to Case Management staff and serves as a resource to providers regarding the authorization process.

Requirements

High school diploma or GED.
Two years 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

Obtain referral or prior authorizations for patients seeing specialty providers.
Complete referrals and/or authorizations accurately and consistently with minimal supervision.
Process authorization and referral requests for Managed Care members in coordination with health plans and contracted providers.
Provide support to Case Management staff.
Serve as a resource to providers regarding the authorization process.