Authorization Coordinator III
About The Position
We are so glad you are interested in joining Sutter Health! Organization: SPMF-Sutter Pacific Medical Foundation - South Position Overview: 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 the Case Management staff. Serves as a resource to providers regarding the authorization process. Initial training required onsite. This role has the opportunity to work at home. The person selected will be required to report to the affiliate, hub location or other Sutter Health facility as requested to meet operational needs.
Requirements
- HS Diploma or GED
- 2 years 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 judgements, 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
- 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.
- Processes authorization and referral requests for members in coordination with health plans and contracted providers.
- Provides support to the Case Management staff.
- Serves as a resource to providers regarding the authorization process.
- Required to report to the affiliate, hub location or other Sutter Health facility as requested to meet operational needs.
Benefits
- Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.
- Eligible positions also include a 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
