Authorization Coordinator III, Home Health
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Job Description
Sutter Health authorization coordinator processing home-health referrals and prior authorizations remotely. Supporting providers, health plans, contracted providers, and case management staff.
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 in Managed Care
- Provides support to Case Management staff
- Serves as a resource to providers regarding the authorization process
Requirements:
- HS Diploma or GED
- AUTO-Automobile Insurance
- Valid Drivers License Class C or B - State Department of Motor Vehicles
- 2 years recent relevant experience
- Medical terminology knowledge
- Current Procedural Terminology (CPT) coding knowledge
- Healthcare Common Procedure Coding System (HCPCS) coding knowledge
- 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
Benefits:
- Eligible positions include a comprehensive benefits package
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