UM Appeals Follow-up Sppt Spec-1

You Belong Here.

At MultiCare, we strive to offer a true sense of belonging for all our employees. Across our health care network, you will find a dynamic range of meaningful careers, opportunities for growth, safe workplaces, and flexible schedules. We are connected by our mission - partnering and healing for a healthy future - and dedicated to the health and well-being of the communities we serve.

FTE: 1.0, Shift: Days, Schedule: Days

Position Summary

The UM Appeals Follow-up 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.

Requirements

• High School or GED
• 1 year post High School business or college course work preferred
• Minimum 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

Our Values

As a MultiCare employee, we'll rely on you to reflect our core values of Respect, Integrity, Stewardship, Excellence, Collaboration and Kindness. Our values serve as our guiding principles and impact every aspect of our organization, including how we provide patient care and what we expect from each other.

Why MultiCare?

• Belonging: We work to create a true sense of belonging for all our employees
• Mission-driven: We are dedicated to our mission of partnering for healing and a healthy future and the patients and communities we serve
• Market leadership: Washington state's largest community-based, locally governed health system
• Employee-centric: Named Forbes “America’s Best Employers by State” for several years running
• Technology: "Most Wired" health care system 15 years in a row
• Leading research: MultiCare Institute for Research & Innovation, 40 years of ground-breaking, clinical and health services research in our communities
• Lifestyle: Live and work in the Pacific Northwest - offering breathtaking water, mountains and forest at every turn

Pay and Benefit Expectations

We provide a comprehensive benefits package, including competitive salary, medical, dental and retirement benefits and paid time off. As required by various pay transparency laws, we share a competitive range of compensation for candidates hired into each position. The pay scale is $21.25 - $30.59 USD. However, pay is influenced by factors specific to applicants, including but not limited to: skill set, level of experience, and certification(s) and/or education. If this position is associated with a union contract, pay will be reflective of the appropriate step on the pay scale to which the applicant’s years of experience align.

Associated benefit information can be viewed here.