Immediate need for a talented Prior Authorization Specialist | EPIC / Referral Management. This is a 12+ Months Contract opportunity with long-term potential and is located in Seattle, WA (Onsite). Please review the job description below and contact me ASAP if you are interested.
Job ID: 26-32024
Pay Range:
$29 - $30/hour. Traveler benefits as per agency package. (Benefits vary by vendor and assignment.)
Key Responsibilities:- Manage high-volume incoming calls from healthcare providers, members, and internal teams.
- Collect and document information required for prior authorization requests.
- Process and update authorization requests in EPIC Tapestry UM and referral management systems.
- Review benefit information, coverage criteria, and supporting documentation.
- Communicate authorization status updates and explain outstanding requirements.
- Research authorization delays, denials, and related administrative issues.
- Identify requests requiring escalation or additional clinical review.
- Apply established processing guidelines and maintain accurate documentation.
- Follow applicable regulatory, compliance, and organizational requirements.
- Deliver professional, timely, and accurate service while managing multiple requests.
- Key Requirements and Technology Experience:
- High School Diploma or GED.Related healthcare, insurance, authorization, referral coordination, or medical administration experience; 3+ years preferred.
- Strong telephone communication, customer service, and call-handling skills.
- Experience with healthcare computer systems and Microsoft Office, including Outlook.
- Excellent reading comprehension, data entry accuracy, and attention to detail.
- Ability to manage a high volume of calls while maintaining service quality.
- EPIC Tapestry UM or other EPIC experience.
- Prior authorization, utilization management, or referral coordination.
- FINESSE or Cisco phone systems.
- Healthcare benefits, eligibility, and coverage review.
- CMS guidelines, Medicare requirements, and medical terminology.
- Familiarity with ICD-10, CPT, and HCPCS.Our client is a leading Healthcare and managed care Industry and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.
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