Prior Authorization Specialist

Authorization Coordinator II

Company
Sutter Health
Location
Emeryville
Posted
Posted yesterday
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The job

We are so glad you are interested in joining Sutter Health!

Organization

SHSO-Sutter Health System Office-Bay

Position Overview

Responsible for performing the appropriate processes to verify patient eligibility, coordinate benefits, ensure insurance coverage, and determine if prior authorization is needed for said order. If needed, obtains authorization and documents in the patient electronic medical record. Facilitates responses to patient inquiries regarding authorizations within turnaround standards.

  • This role has the opportunity to work at home. The person selected must live in the Northern California Sutter Health footprint and be available to come on site occasionally as needed.*

Job Description

EDUCATION

  • HS Diploma or GED

TYPICAL EXPERIENCE

  • 1 year recent relevant experience.

SKILLS AND KNOWLEDGE

  • 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 judgments, 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.

Job Shift

Days

Schedule

Full Time

Shift Hours

8

Days of the Week

Monday - Friday

Weekend Requirements

As Needed

Benefits

Yes

Unions

No

Position Status

Non-Exempt

Weekly Hours

40

Employee Status

Regular

Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.

Pay Range is $33.06 to $46.28 / hour

The compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate’s experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is only one component of Sutter Health’s comprehensive total rewards program. Eligible positions also include a comprehensive benefits package.

Posted by Sutter Health. Some listings are shortened, so open the full posting for the rest.

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