Authorizations Coordinator I (Hybrid) - 26-11

PriMed Management Consulting • Sacramento, CA

1d • $26 - $29 • Hybrid

About The Position

Coordinate the authorization process and support the Health Resources Management Department (HRM).

Requirements

• Medical Assistant certification and/or 1-3 years of Healthcare experience preferred
• Strong knowledge of medical terminology
• Working knowledge of CPT/ICD10 & HCPCS codes
• Accurate data entry and Microsoft Office skills (intermediate).
• Strong verbal communication, decision-making and problem solving skills
• Strong organizational skills and detail oriented
• Ability to work independently and as part of a team
• Able to multi-task and work in a productivity-based environment
• H.S. Diploma or GED

Nice To Haves

• Epic/Tapestry experience is a plus

Responsibilities

• Complete authorization requests in accordance to the operational procedures outlined within the HRM Operations Manual and Policy Provisions.
• Researching and troubleshooting complex authorization rules to render the correct decision based on members’ benefits, a Health Plans’ contractual arrangements, and specific criteria to determine if service may be authorized.
• Enter authorization data into Epic database using correct types and codes.
• Answer phone queue line calls in accordance with departmental standards.
• Monitor Customer Service Requests (CSR) activity; respond appropriately within department standards.
• Serve as resource for customer service.
• Maintain open lines of communication within all departments of the organization.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED