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SGA Inc.

Authorization Coordinator I - REMOTE

emeryville, CA

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Job description

Authorization Coordinator ISoftware Guidance & Assistance, Inc., (SGA), is searching for an Authorization Coordinator I for a Contract assignment with one of our premier Healthcare clients working remotely.Responsibilities:The Authorization Coordinator I processes patient referral requests to support timely and accurate determinations. This role reviews referrals according to standard work, health plan contracts, and utilization management protocols, forwarding requests to nurses or physicians when required.The coordinator monitors pending referrals, maintains turnaround-time standards, documents referral updates and determinations, and assists providers and patients with status questions.The position requires strong attention to detail, medical terminology knowledge, and effective communication of medical concepts and issues.The coordinator also identifies workflow problems, reports anticipated delays, and supports process improvements. Success requires organized remote work habits, sound judgment, adaptability, and the ability to manage changing priorities while maintaining accuracy.Required Skills:MUST HAVE EPIC EXPERIENCE1+ year experience in healthcare administration, referrals, authorizations, or managed careExperience processing referrals according to protocols, health plan requirements, and turnaround timesProficiency in medical terminology and healthcare workflowsExperience with Microsoft Excel, Word, and managed care systemsAbility to document referral status and determinations accuratelyAbility to identify, understand, and resolve referral-related issuesPreferred Skills:Experience in a health plan, medical group, or utilization management settingKnowledge of CPT, HCPCS, and ICD-9 codingExperience obtaining medical information for authorization determinationsExperience monitoring pending referrals and escalating anticipated delaysBy applying for a job with SGA, you agree to allow SGA to process your application for this and future opportunities in accordance with our Privacy Policy. Also, to ensure timely processing, you agree to be contacted by our AI recruiter via email, text, or phone. Message frequency varies and data rates may apply, but you can reply STOP to any SMS message to opt-out of texts and may contact SGA at to opt-out of AI communications. The choice not to engage with AI will not adversely impact your consideration for placement. AI is not used to make any hiring determinations. SGA is a technology and resource solutions provider driven to stand out. We are a women-owned business. Our mission: to solve big IT problems with a more personal, boutique approach. Each year, we match consultants like you to more than 1,000 engagements. When we say let's work better together, we mean it. You'll join a diverse team built on these core values: customer service, employee development, and quality and integrity in everything we do. Be yourself, love what you do and find your passion at work. Please find us at . SGA is an Equal Opportunity Employer and does not discriminate on the basis of Race, Color, Sex, Sexual Orientation, Gender Identity, Religion, National Origin, Disability, Veteran Status, Age, Marital Status, Pregnancy, Genetic Information, or Other Legally Protected Status. We are committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment, and our services, programs, and activities.

Worksite address

emeryville, CA, 94608, US

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