Top 153 Prior authorization Jobs in Seattle, Wa

Utilization Management Coordinator I
Community Health Plan of Washington —Seattle, WA
- $21.00 - $28.98 an hour
- Full-time
- Remote
- Research
- Office
- Analysis skills
- Paid jury duty
- Health savings account
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7d
Pharmacy Billing Technician
Fred Hutchinson Cancer Center —Seattle, WA
- $35.09 - $52.63 an hour
- Full-time
- Remote
- Computer literacy
- Pass drug screening
- Mid-level
- Paid parental leave
- Paid holidays
2d
Patient Authorization and Referral Representative - Patient Access
Pacific Medical Centers —Seattle, WA
- $22.62 - $35.22 an hour
- Full-time
- Hybrid work
- Hospital
- Research
- Mid-level
- Paid parental leave
- Paid holidays
1d
Authorization & Benefits Specialist
Proliance Surgeons, Inc. —Renton, WA
- $21.57 - $31.95 an hour
- Full-time
- HIPAA
- Mid-level
- High school diploma or GED
- Health insurance
- Paid time off
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Pharmacy Technician - Infusion Authorization
University of Washington —Seattle, WA
- $31.86 - $46.98 an hour
- Full-time
- Acute care
- Pass drug screening
- Entry level
Customer Solutions Specialist - Seattle, WA
AbbVie —Seattle, WA
- $84,500 - $162,000 a year
- Full-time
- Remote
- Computer literacy
- Mid-level
- Windows
- Paid holidays
- Health insurance
4d
Patient Access Coordinator
Fred Hutchinson Cancer Center —Seattle, WA
- $25.72 - $36.62 an hour
- Full-time
- Bilingual
- Computer literacy
- Bachelor of Science
- Paid parental leave
- Paid holidays
1d
Surgery Scheduler - Neurosurgical Care
EvergreenHealth —Kirkland, WA
- $26.16 - $41.82 an hour
- Full-time
- Anatomy knowledge
- Surgery
- Mid-level
- Free parking
- Commuter assistance
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Pharmacy Tech II Cert Specialty Pharmacy
Virginia Mason Medical Center —Seattle, WA
- $33.30 - $45.78 an hour
- Full-time
- Mid-level
- High school diploma or GED
- Organizational skills
Specialty Services Coordinator
Valley Medical Center —Renton, WA
- $24.92 - $41.65 an hour
- Full-time
- Windows
- High school diploma or GED
- Clinic
Pharmacy Technician 2 - Specialty Pharmacy
University of Washington —Seattle, WA
- $31.86 - $46.98 an hour
- Part-time
- Pass drug screening
- Entry level
- Under 1 year
- Prescription drug insurance
Manager, Prior Authorizations
Kestra Medical Technologies Inc. —Kirkland, WA
- $100,000 - $120,000 a year
- Extended hours
- Remote
- Bachelor's degree
- Travel
- US work authorization
- Health insurance
- Dental insurance
Quick Apply
2d
Patient Access Associate
Valley Medical Center —Renton, WA
- $22.17 - $37.05 an hour
- Full-time
- Hospital
- Computer literacy
- Windows
10d
Admissions Coordinator, Home Health
Wesley At-Home —Federal Way, WA
- $26.04 - $37.53 an hour
- 8 hour shift
- Ability to walk for extended periods
- Writing skills
- English
- Paid holidays
- Health insurance
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2d
Associate Patient Care Coordinator - Administration
Pacific Medical Centers —Seattle, WA
- $21.30 - $31.48 an hour
- Full-time
- Fair chance
- Entry level
- Under 1 year
- Paid parental leave
- Paid holidays
Patient Registration Specialist
Northwest Asthma & Allergy Center —Seattle, WA
- $22 - $28 an hour
- Full-time
- Background check
- Microsoft Outlook
- Adults
- Profit sharing
- AD&D insurance
Quick Apply
Financial Advocacy Associate
Valley Medical Center —Renton, WA
- $25.92 - $43.32 an hour
- Full-time
- Microsoft Word
- Microsoft Outlook
- Hospital
Case Manager - SUDP (PT, Days)
Connections Health Solutions —Kirkland, WA
- $2.00 - $41.23 an hour
- 12 hour shift
- Addiction Medicine
- Mid-level
- Experience working with children
- Paid parental leave
- Health savings account
Quick Apply
Travel Medical Assistant - Oncology
Axis Medical Staffing —Kirkland, WA
- $1,500 - $1,600 a week
- Temporary
- Background check
- BLS Certification
- Mid-level
- Travel reimbursement
- Health insurance
Quick Apply
9d
Patient Care Coordinator
Aya Healthcare —Issaquah, WA
- $23 - $26 an hour
- Contract
- Background check
- Medical office experience
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
2d

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Utilization Management Coordinator I

Community Health Plan of Washington -
Seattle, WA

Quick Apply

Job Details

Full-time
$21.00 - $28.98 an hour
7 days ago

Benefits

Paid jury duty
Health savings account
AD&D insurance
Disability insurance
Health insurance
Dental insurance
Flexible spending account
Paid time off
Employee assistance program
Vision insurance
401(k) matching

Qualifications

Customer communication
Research

Full Job Description

Who we are

Community Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to any actual or perceived protected characteristic or other unlawful consideration.

Our commitment is to:

Strive to apply an equity lens to all our work.
Reduce health disparities.
Create an equitable work environment.

About the Role:

The level I UM Coordinator is responsible for administrative functions in processing Utilization Management (UM) organization determinations for services requiring authorization and hospital notification. Utilizing knowledge of Medicare and Medicaid guidelines to facilitate and comply with the UM processes in data entry of authorization requests, eligibility verification, benefit determinations, timely letter fulfilment, and support to UM clinical staff.

To be successful in this role, you:

Have an associate degree, or an equivalent combination of education and highly relevant experience.
Have at least one (1) year of customer service experience, preferred.
Have working experience in a Healthcare setting, preferred.
Have working experience in a Managed Care setting, preferred.
Are knowledgeable of medical terminology and healthcare processes, preferred.
Are knowledgeable of Washington Apple Health and Medicare Advantage Plans, preferred.

Essential functions and Roles and Responsibilities:

Performs data entry for all referral, prior authorizations and hospital notifications; attaches and/or includes clinical documents as needed.
Utilizes knowledge to determine appropriate CPT, HCPC, ICD-10 codes using CMS, NCQA and HCA criteria.
Researches and validates benefit and prior authorization requirements to determine appropriate course of action within the Care Management system.
Reviews, corrects, and approves authorization requests via the web portal; determines appropriate level of complexity and refers cases requiring clinical review to a nurse reviewer.
Reviews completed denial letters for accuracy and adherence to compliance deadlines. Edits and proofreads content for appropriate medical terminology and MCG criteria. Ensures letters are mailed within established timeframes.
Accurately applies policies & procedures, benefit and eligibility standards to all incoming requests.
Conducts research, validates data, and responds to complex inquiries from multiple sources, including but not limited to members, nurses, medical providers, customer service, operations, appeals, case management and care coordination. Escalating issues as needed.
Reporting to work on time and for all scheduled shifts is essential to this position.
Other duties as assigned. Essential functions listed are not necessarily exhaustive and may be revised by the employer, at its sole discretion.

Knowledge, Skills, and Abilities:

Solid analytical skills and the ability to interpret, evaluate and formulate action plans based upon data.
Knowledge of care management workflow systems.
Effective verbal and written communication skills. Able to communicate with and collaborate effectively with physicians and allied health care providers.
Flexibility and willingness to work in a matrix-management environment.
Demonstrated organizational, time management, and project management skills.
Ability to multi-task and deal with complex assignments on a frequent basis.
Demonstrated proficiency and experience with Microsoft Office products.
Ability to work independently.
Collaborate with others in a respectful manner and ability to maintain confidentiality.
Perform all functions of the job with accuracy, attention to detail and within established timeframes.

As part of our hiring process, the following criteria must be met:

Complete and successfully pass a criminal background check

Criminal History: includes review of criminal convictions and probation. CHPW does not automatically or categorically exclude persons with a criminal background from employment. The applicant’s criminal history will be reviewed on a case-by-case basis considering the risk to the business, members, and/employees.

Has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency
Vaccination requirement (CHPW offers a process for medical or religious exemptions)
Candidates whose disabilities make them unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation.

Compensation and Benefits:

The position is FLSA Non-Exempt and is not eligible for overtime. Based on market data, this position grade is 38 (see full range below) and has a 5% annual incentive target based on company, department, and individual performance goals.

CHPW offers the following benefits for Full and Part-time employees and their dependents:

Medical, Prescription, Dental, and Vision
Telehealth app
Flexible Spending Accounts, Health Savings Accounts
Basic Life AD&D, Short and Long-Term Disability
Voluntary Life, Critical Care, and Long-Term Care Insurance
401(k) Retirement and generous employer match
Employee Assistance Program and Mental Fitness app
Financial Coaching, Identity Theft Protection
Time off including PTO accrual starting at 17 days per year.
40 hours Community Service volunteer time
10 standard holidays, 2 floating holidays
Compassion time off, jury duty

Sensory/Physical/Mental Requirements:

Sensory*:

Speaking, hearing, near vision, far vision, depth perception, peripheral vision, touch, smell, and balance.

Physical*:

Extended periods of sitting, computer use, talking and possibly standing
Simple grasp, firm grasp, fine manipulation, pinch, finger dexterity, supination/pronation, wrist flexion
Frequent torso/back static position; occasional stooping, bending, and twisting.
Some kneeling, pushing, pulling, lifting, and carrying (not over 25 pounds), twisting, and reaching.

Mental:

Ability to learn and prioritize multiple tasks at a given time and have the capability of handling demanding situations. Analytical/problem solving/critical thinking ability.

Work Environment:

Office environment Employees who frequently work in front of computer monitors are at risk for environmental exposure to low-grade radiation.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.

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Refine Your Search

prior authorization jobs in seattle, wa

Utilization Management Coordinator I

Pharmacy Billing Technician

Patient Authorization and Referral Representative - Patient Access

Authorization & Benefits Specialist

Pharmacy Technician - Infusion Authorization

Customer Solutions Specialist - Seattle, WA

Patient Access Coordinator

Surgery Scheduler - Neurosurgical Care

Pharmacy Tech II Cert Specialty Pharmacy

Specialty Services Coordinator

Pharmacy Technician 2 - Specialty Pharmacy

Manager, Prior Authorizations

Patient Access Associate

Admissions Coordinator, Home Health

Associate Patient Care Coordinator - Administration

Patient Registration Specialist

Financial Advocacy Associate

Case Manager - SUDP (PT, Days)

Travel Medical Assistant - Oncology

Patient Care Coordinator

I want to receive the latest job alert for prior authorization in seattle, wa

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