Authorization Coordinator, Sutter Infusion Pharmacy

Sutter Health•Sacramento, CA

2d•$27 - $35•Onsite

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 the Case Management staff. Serves as a resource to providers regarding the authorization process.

Requirements

HS Diploma or equivalent education/experience
2 years working in a health care setting and insurance verification.
2 years experience working with insurance prior authorizations, referrals and working with electronic health record.
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

Obtaining referral or prior authorizations for patients to see specialty providers.
Completing referrals and/or authorizations accurately and consistently with minimal supervision.
Processing authorization and referral requests for members in coordination with health plans and contracted providers.
Providing support to the Case Management staff.
Serving as a resource to providers regarding the authorization process.