Hiring Organization / Company: Seattle Childrens Hospital
Basic Salary: To Be Discussed
Employement Type: Full-Time
Responsible for fulfilling Hospital Utilization Management policies and procedures by performing review of scheduled or unscheduled patient admissions from admit date through discharge for appropriate level of care classification. Applies knowledge of nationally recognized admission criteria, (InterQual and MCG) hospital guidelines of care, clinical pathways and evidence based practices to analyze the patient medical record and make level of care classification decisions. Communicates review decisions with patient's health plan and obtains health plan authorization for reimbursement of admission Works in partnership with the health care team to resolve classification or authorization issues.
Required Education/Experience: - High School Diploma or equivalent. - Minimum of four (4) years experience with progressive responsibilities in health care facility administrative support functions such as insurance processing coordinator, inpatient team coordinator, documentation specialist, case management or related roles. For Psychiatry Utilization Review: requirements as stated above OR a Bachelor's Degree in a health or business related field and two (2) years of experience providing clinical services, case management in an inpatient or outpatient mental health setting or insurance processing/claims processing in a hospital setting. Preferred: - Experience in mental health utilization review.
- Bachelor's degree in a health related field. - Clinical or technical training as an RN, PHN, or Nurse Asst-Cert (NAC). - Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA).
Our Commitment to Diversity
Our community welcomes diverse experiences, backgrounds, and thoughts as this is what drives our spirit of inquiry and allows us to better connect with our increasingly diverse patients and families. Our organization recruits, employs, trains, compensates, and promotes without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.
The people who work at Seattle Children's are members of a community that seeks to respect and celebrate all the qualities that make each of us unique. Each of us is empowered to be ourselves within this community, which cultivates and promotes equity, diversity, and inclusion at all levels.
Seattle Children's is proud to be an Equal Opportunity Workplace and Affirmative Action Employer.
Job Location Information:
Location: Seattle, Wa
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