Job description
Organization:
SPMF-Sutter Pacific Medical Foundation - NorthPosition Overview:
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.Job Description:
EDUCATION
- Equivalent experience will be accepted in lieu of the required degree or diploma.
- HS Diploma or equivalent education/experience
PREFERRED EXPERIENCE AS TYPICALLY ACQUIRED IN:
- 2 years experience working in a health care setting and insurance verification.
- 2 years experience working with insurance prior authorizations, referrals and working with electronic health record.
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 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.
Job Shift:
DaysSchedule:
Full TimeShift Hours:
8Days of the Week:
Friday, Monday, Thursday, Tuesday, WednesdayWeekend Requirements:
NoneBenefits:
YesUnions:
NoThis position is work from home eligible.
Position Status:
Non-ExemptWeekly Hours:
40Employee Status:
RegularNumber of Openings:
1Sutter Health Affiliates are equal opportunity employers EOE/M/F/Disability/Veterans.
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