Organization:

SPMF-Sutter Pacific Medical Foundation - North

Position 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.

Pay Range: $27.67-$34.58

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.

Job Shift:

Days

Schedule:

Full Time

Shift Hours:

8

Days of the Week:

Friday, Monday, Thursday, Tuesday, Wednesday

Weekend Requirements:

None

Benefits:

Yes

Unions:

No

This position is work from home eligible.

Position Status:

Non-Exempt

Weekly Hours:

40

Employee Status:

Regular

Number of Openings:

1

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