The reasons to work at MultiCare are as unique as the people who do. Join us for the professional challenges you seek. In the settings you prefer. With schedules that fit your life. Learn more at www.multicarejobs.org Position Summary: Minimum Requirements: Education/Licenses/Certifications:
The Utilization/Appeals Support Specialist obtains service authorization, performs ongoing updates and assists with monitoring authorization compliance for Medicare and Non-Medicare funded services to ensure MultiCare receives appropriate authorization and financial reimbursement for provided care. This position will help support the UM department functions by performing pertinent research, evaluating and responding to clinical information requests and assisting with the completion of the appeals process and other inquiries in accordance with all established regulatory guidelines and department standards. Prepares appeal summaries and correspondence and documents information for tracking/trending data. Serves as a liaison with Medicare and with non-Medicare funding entities.
Two (2) years medical insurance, medical records or medical office experience required
Medicare, State, Hospice, HMO, PPO and traditional insurance regulation experience preferred.
EPIC or electronic medical record experience preferred
Experience in managed care desired
High School or GED
1 year post High School business or college course work preferred
MultiCare is an equal opportunity employer. Hiring decisions are made without regard to race, color, religion, national origin, sexual orientation, gender identity, disability or veteran status. EOE/AA/M/F/D/V
MultiCare is a smoke-free, drug-free workplace. All employment offers are contingent upon acceptable pre-employment drug tests which include testing for the use of marijuana and nicotine. As part of our commitment to a healthy workplace, we require employees to obtain an annual flu immunization.
If you are a job applicant who requires reasonable accommodation in the job application process, please contact our Candidate Experience Team at firstname.lastname@example.org.