Pacific Medical Centers Member Services Navigator-USFHP in Seattle, Washington
Find what you’re looking for in your career, at PacMed as a USFHP Member Navigator in Seattle, WA.
This is a full time opportunity and is available for full benefits.
The USFHP Member Navigator will act as the primary liaison and navigator for all members. In addition to responding to Customer Service Requests and resolving problem claims, referrals and billing situations. the Member Navigator will provide back-up and vacation coverage to other USFHP areas as needed.
In this position you will:
Provide excellent customer service to all USFHP members and promote an efficient and smooth referral process.
Respond to written and direct member inquiries which includes timely, accurate and thorough responses to telephone, written as well as explanation/verification of benefits, customer education, resolution for both internal and external complaints and patient advocacy.
Determine delegation status of claims and prepare claim for submission to appropriate entity.
Assist in the absence of staff members or temporary work overload situations.
Required qualifications for this position include:
High school Diploma or GED and/or equivalent experience in Health Care Business Administration.
Excellent customer service skills and experience.
Information systems supporting the administration of managed care products
Typing and 10-key skills (40 wpm and 100 spm) and CRT experience.
Preferred qualifications for this position include:
Experience with managed care insurance.
Experience with GE Centricity healthcare software application
CHAMPUS/Tricare, Medicare, and/or Medicaid benefits/programs
Pacific Medical Center :
Pacific Medical Center is an expanding network of outpatient clinics providing primary and specialty care to the greater Seattle area and employing more than 150 providers representing most medical specialties. Pacific Medical Centers is affiliated with Providence Health & Services, which operates 28 exceptional not-for-profit hospitals and more than 350 clinics across the West. With hundreds of physician and advanced practice provider opportunities in virtually all specialties at any given time, Pacific Medical Centers and Providence offer diverse locations, lifestyles and practice models. Find what you are looking for in your next practice opportunity with Pacific Medical Centers! Learn more at www.pacmed.org/providerjobs .
We offer a full comprehensive range of benefits — see our website for details —
Our mission is to provide respectful, high-quality, patient-focused healthcare to each person and to the communities we serve.
Quality and respect. These are the words Pacific Medical Centers (PacMed) employees live and work by. PacMed is a private, not-for-profit, primary and integrated multispecialty health care network with 10 outpatient clinics across the Puget Sound region and more than 175 primary and specialty care providers. Affiliated with the Providence Health & Services system, PacMed provides patient-focused health care — and even same-day appointments — to patients in King, Snohomish and Pierce counties. We provide immediate access to cutting-edge technology, first-class facilities and board-certified specialists, many of whom have been listed as among “Seattle’s Best Doctors.”
Pacific Medical Centers, PacMed, and their Affiliates' (collectively “PacMed”) comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability, or sex. PacMed does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
Job Category: Billing/Insurance
Req ID: 213932