Employer Industry: Healthcare Services

Why consider this job opportunity:
- Salary up to $33.22 per hour
- 8 weeks of paid training to support your career growth
- Comprehensive benefits package, including 401k contributions and equity stock purchase options
- Opportunity for career advancement and development within a leading healthcare organization
- Flexible remote work option available for residents of WA
- Supportive and inclusive company culture focused on health equity

What to Expect (Job Responsibilities):
- Initiate and manage referral authorizations in compliance with health plan agreements
- Provide administrative support and gather necessary information for processing referrals and authorization requests
- Act as a liaison between providers, patients, and health plans to facilitate the Utilization Management process
- Review and document patient information accurately in the electronic health record
- Research and process denied claims due to missing authorizations or referrals

What is Required (Qualifications):
- High School Diploma / GED
- Minimum of 2 years of experience in healthcare with knowledge of health plan operations
- Experience in Utilization Management and claims billing
- Proficiency in Microsoft Outlook, Word, Teams, and EHR/EMR systems such as Epic
- Ability to work full-time with flexible scheduling during normal business hours

How to Stand Out (Preferred Qualifications):
- 1+ years of experience specifically in Utilization Management
- Experience in appeal writing and processing
- Familiarity with EOB, COB, Remits, and CMS 1500 forms
- Knowledge of organizational policies and procedures
- Understanding of CPT & Diagnosis Coding, Medical Terminology, and basic Anatomy

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