Referral and Authorization Coordinator III, Urology
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. Initial training will be onsite with the potential to be hybrid thereafter. Candidate must live in one of the following Sutter Pacific Medical Foundation approved states: California.
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
- Candidate must live in California
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.
Benefits
- 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
