Job Information
Sutter Health Prior Auth Coordinator I, GI, Limited Term in Fremont, California
Organization:
PAMF-Palo Alto Medical Foundation ALD
Position Overview:
Processes referral requests for patients to achieve timely and accurate determinations. Works within scope of practice to complete or forward requests as appropriate to Managed Care physicians and/or nurses as per the Utilization Management (UM) protocols. Maintains required turnaround times for referral completion. Assists providers and patients with referral status questions. Participates in development and implementation of improvements to the referral process and workflows.
This position is hybrid/mobile. Initial onboarding and training will be onsite in the Fremont and Dublin, California offices.
Job Description :
This position is hybrid/mobile. Initial onboarding and training will be onsite in the Fremont and Dublin, California offices.
EDUCATION:
HS Diploma or GED
SKILLS AND KNOWLEDGE:
Medical terminology, Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS)/International Classification of Diseases (ICD)-9 coding knowledge.
Competency in using MS Office Excel and Word, other Managed Care programs.
Ability to identify, understand and solve problems related to claims and referrals.
Communication skills, including understanding of medical concepts, ability to organize thoughts, and communicate issues concisely and effectively.
Proven ability to quickly adjust to changing projects and priorities and to multi-task.
Organizational skills.
Job Shift :
Days
Schedule :
Full Time
Shift Hours:
8
Days of the Week:
Monday - Friday
Weekend Requirements:
None
Benefits:
Yes
Unions:
No
This position is work from home eligible.
Position Status:
Non-Exempt
Weekly Hours:
40
Employee Status:
Limited Term (Fixed Term)
Number of Openings:
1
Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.
Pay Range is $29.19 to $36.48 / 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.
All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, marital status, sexual orientation, registered domestic partner status, sex, gender, gender identity or expression, ancestry, national origin (including possession of a driver's license issued to individuals who did not present proof of authorized presence in the U.S.), age, medical condition, physical or mental disability, military or protected veteran status, political affiliation, pregnancy or perceived pregnancy, childbirth, breastfeeding or related medical condition, genetic information or any other characteristic made unlawful by local, state, or federal law, ordinance or regulation. External hires must pass a background check/drug screening. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state, and local laws, including but not limited to the San Francisco Fair Chance Ordinance.