Prior Authorization Specialist UW Medicine Primary Care at Northgate

UW Medicine Primary Care - Prior Authorization Team has an outstanding opportunity for a Patient Services Specialist 2- Prior Authorization Specialist.

WORK SCHEDULE

• Full-time 100% FTE (40 hours per week)
• Monday - Friday; 8am-5pm
• Day Shift

DEPARTMENT DESCRIPTION

Conveniently located along I-5 near the Northgate Transit Center UW Medicine Primary Care at Northgate offers primary care appointments six days a week including evenings and same-day appointments.

Board-certified providers offer a complete spectrum of primary care services including family medicine with obstetrics geriatrics behavioral health travel medicine nutrition services reproductive health and sports medicine. An on-site lab and digital X-ray facilities are available to you.

POSITION HIGHLIGHTS

• Help patients receive coverage for their medications
• Make a difference for the patients and employees we serve
• Opportunity to provide career growth

PRIMARY JOB RESPONSIBILITIES

• Work with patients referring/prescribing providers specialty clinic providers and staff Contact Center representatives and other appropriate individuals to facilitate referrals to the UW Medicine Health System and to process prior authorizations
• Process referrals/prior authorization in accordance with UW Medicine standards ensuring all are processed within 1 day of the provider order and all relevant information is entered into EpicCare. Creates and pends referral orders according to network guidelines
• Manage urgent referrals/prior authorizations to expedite the scheduling & communication with the receiving specialty department and / or 3rd party insurance company.
• Work with receiving clinic and/or referring/ordering provider to help facilitate the timely provision of care. Pre-verify submit required paperwork/supporting materials and receive authorization with third party insurance companies to assist in making referrals to specialty providers and/or processing prior authorizations.
• Utilize online insurance portals to verify benefits prior to processing referrals and/or authorizations and maintain familiarity with internal resources related to insurance contracting and requirements.
• Serve as a resource for patients and providers in understanding insurance requirements and/or limitations as they relate to referrals and medications that require prior authorization

REQUIREMENTS

• High school graduation or equivalent AND
• One year of healthcare administrative or customer service experience
• OR an equivalent combination of education/experience

ABOUT UW MEDICINE PRIMARY CARE

UW Medicine Primary Care is a network of clinics located throughout the Puget Sound region. The clinics offer a wide spectrum of primary care services as well as secondary care from pediatrics to geriatrics. Urgent care services are offered seven days a week at select locations.

UW Medicine Primary Care is dedicated to improving the health of the public; our providers and staff are the cornerstones of our success. The foundation of our efforts to deliver exceptional care to our patients and families begins with our focus on the continuous development of our employees.

Compassion. Innovation. Excellence.

ABOUT UW MEDICINE WHERE YOUR IMPACT GOES FURTHER

UW Medicine is Washingtons only health system that includes a top-rated medical school and an internationally recognized research center. UW Medicines mission is to improve the health of the publicby advancing medical knowledge providing outstanding primary and specialty care to the people of the region and preparing tomorrows physicians scientists and other health professionals.

All across UW Medicine our employees collaborate to perform the highest quality work with integrity and compassion and to create a respectful welcoming environment where every patient family student and colleague is valued and honored. Nearly 29000 healthcare professionals researchers and educators work in the UW Medicine family of organizations that includes: Harborview Medical Center UW Medical Center - Montlake UW Medical Center - Northwest Valley Medical Center UW Medicine Primary Care UW Physicians UW School of Medicine and Airlift Northwest.

Become part of our team. Join our mission to make life healthier for everyone in our community.