Offer summary

Qualifications:

High School Diploma or GED required., 1 year of relevant experience preferred, especially in Utilization Management or prior Authorization., Knowledge of medical terminology and coding systems (CPT, HCPCS, ICD-9)., Proficiency in Microsoft Office programs and strong organizational skills..

Key responsibilities:

Verify patient eligibility and coordinate benefits for insurance coverage.

Determine the need for prior authorization and obtain it when necessary.

Document authorizations in the patient electronic medical record.

Respond to patient inquiries regarding authorizations within established turnaround standards.

Job description

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.

Job Description:

EDUCATION:

HS Diploma or GED

PREFERRED EXPERIENCE AS TYPICALLY ACQUIRED IN:

1 year recent relevant experience.
Utilization Management or prior Authorization experience preferred.

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:

Days of the Week:

Monday - Friday

Weekend Requirements:

None

Benefits:

Yes

Unions:

Position Status:

Non-Exempt

Weekly Hours:

Employee Status:

Regular

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

Pay Range is $0.00 to $0.00 / hour. California - Valley Range Pay Range is $27.09 to $33.86 / hour.

The salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate’s experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package.

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