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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.
Minimum Requirements: 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
Education/Licenses/Certifications: High School or GED 1 year post High School business or college course work preferred
Position Type: Part Time - Regular Full Time Employee: NoPrimary Shift: Day Work Schedule: Day
MultiCare is a not-for-profit health care organization with more than 20,000 team members, including employees, providers and volunteers. MultiCare has been caring for our community for well over a century, since the founding of Tacoma’s first hospital and today is the largest community-based, locally governed system of health in the state of Washington, serving communities across Washington and Northern Idaho.
MultiCare’s comprehensive system of health includes numerous primary care, urgent care and specialty services — including Mary Bridge Children’s Hospital & Health Network; MultiCare Indigo Urgent Care; Pulse Heart Institute; MultiCare Medical Associates, affiliated physicians; MultiCare Rockwood Clinic, the largest multispecialty clinic in the Inland Northwest region; and MultiCare Connected Care, our Accountable Care Organization.
Eleven hospitals complete the organization: Allenmore Hospital, Auburn Medical Center, Capital Medical Center, Covington Medical Center, Deaconess Hospital, Good Samaritan Hospital, Mary Bridge Children’s Hospital — the Puget Sound region’s only children’s hospital and state-designated Level II Pediatric Trauma Center for Western Washingt...on — Navos Behavioral Health Hospital, Valley Hospital, Tacoma General Hospital — which is home to the South Puget Sound region’s only Level IV Neonatal Intensive Care Unit — and Wellfound Behavioral Health Hospital.
Our core values of Respect, Integrity, Stewardship, Excellence, Collaboration and Kindness, 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.
MultiCare is also proud of our commitment to workforce diversity and culturally competent care. This commitment is led by our CEO and supported through employee education and community outreach.