Pacific Medical Centers Referral Coordinator-Uniformed Services Family Health Plan in Seattle, Washington

Description:

Find what you’re looking for in your career, at PacMed as a Uniformed Services Family Health Plan - Referral Coordinator in Seattle, WA.

This is a full time position and is eligible for benefits.

We are seeking a USFHP Referral Coordinator provides the administrative functions needed to support a smooth, efficient referral process.

In this position you will:

  • Assist the utilization review and case management nurse with management of referrals an monitoring or institutional patients.

  • Review all referrals for eligibility and benefits and consults with the appropriate areas for clarification or assistance.

  • Make coverage decisions based on PMC approval criteria or TRICARE policy and procedure as appropriate.

  • Coordinate referral activities and first level of complaints with Member Services Representatives.

  • Assist in the collection of other insurance information from providers to facilitate appropriate Coordination of Benefits (COB).

Qualifications:

Required qualifications for this position include:

  • High school diploma or equivalent;

  • Two years’ experience in medical related field.

  • Previous experience in UR, health plan, or managed care environment.

Preferred qualifications for this position include:

  • LPN or health data services coder.

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 —

http://pacmed.jobs/benefits/

Our Mission

Our mission is to provide respectful, high-quality, patient-focused healthcare to each person and to the communities we serve.

About Us

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.

Schedule: Full-time

Shift: Day

Job Category: Administrative (Clinical)

Location: Washington-Seattle

Req ID: 207028