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Healthcare Authorization Specialist

1 week ago

Sacramento, California, United States Hill Physicians Medical Group Full time

Hill Physicians Medical Group is shaping the future of healthcare with proactive, managed care that prevents disease, supports those with chronic conditions, and anticipates the needs of our members.

About Us

We value and respect your race, ethnicity, gender identity, sexual orientation, age, religion, disabilities, experiences, perspectives, and other attributes. Our celebration of diversity and foundation of inclusion allows us to leverage our differences and capitalize on our similarities to better serve our communities.

Job Summary

The Authorization Representative I coordinates the authorization process and supports the Health Resources Management Department (HRM). Key responsibilities include:

  • Completing authorization requests in accordance with HRM operations manual and policy provisions
  • Researching and troubleshooting complex authorization rules to render correct decisions based on members' benefits, health plans' contractual arrangements, and specific criteria
  • Entering authorization data into Epic database using correct types and codes
  • Answering phone queue line calls in accordance with departmental standards
  • Maintaining open lines of communication within all departments of the organization