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Prior Auth Coordinator I, GI, Limited Term

Job ID R-66600 Date Posted 05/06/2024 Location Fremont, Alameda, CA | Dublin, CA Schedule/Shift/Weekly Hours Limited Term (Fixed Term)/Days/40

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.

Qualified applicants with arrest and conviction records will be considered for employment. Applicants for specific positions are still required to disclose certain convictions during the application process, and those convictions may also be considered in determining eligibility for employment in accordance with applicable law.

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