Authorization Coordinator, Hospice, Work From Home

About the role

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.

Responsibilities

• Obtain referral or prior authorizations for patients to see specialty providers
• Complete referrals and/or authorizations accurately and consistently with minimal supervision
• Process authorization and referral requests for members in coordination with health plans and contracted providers (Managed Care)
• Provide support to Case Management staff
• Serve as a resource to providers regarding the authorization process

Requirements

• HS Diploma or GED
• Current Automobile Insurance certification (AUTO) – Home Health department (remote employees excluded)
• Valid Driver’s License (DL) – Home Health department (remote employees excluded)
• Typically 2 years of recent relevant experience

Skills

• Medical terminology
• Knowledge of CPT/HCPCS/ICD-9 coding
• Knowledge of medical terminology/anatomy
• Ability to exercise discretion and make independent judgments, seeking review when decisions represent significant departure from established guidelines
• Proficiency with Microsoft Office programs (Excel, Word, or similar)
• Ability to maintain composure during challenging interpersonal interactions
• Active listening and interpersonal skills, including telephone communication
• Organizational skills with attention to detail and follow-up

Benefits

Eligible for a comprehensive benefits package.

Pay

• Pay range: $22.28 to $31.20 per hour
• Compensation may vary based on geographic location
• Total compensation considers experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs
• Base pay is one component of Sutter Health’s total rewards program

Schedule

• Full-time position
• Shift hours: 8 hours per day
• Days of the week: variable
• Weekend requirements: rotating weekends
• Weekly hours: 40