Authorization Appeals Coordinator Jobs

Overview

Fred Hutchinson Cancer Center is an independent, nonprofit organization providing adult cancer treatment and groundbreaking research focused on cancer and infectious diseases. Based in Seattle, Fred Hutch is the only National Cancer Institute-designated cancer center in Washington.

With a track record of global leadership in bone marrow transplantation, HIV/AIDS prevention, immunotherapy and COVID-19 vaccines, Fred Hutch has earned a reputation as one of the world’s leading cancer, infectious disease and biomedical research centers. Fred Hutch operates eight clinical care sites that provide medical oncology, infusion, radiation, proton therapy and related services, and network affiliations with hospitals in five states. Together, our fully integrated research and clinical care teams seek to discover new cures to the world’s deadliest diseases and make life beyond cancer a reality.

At Fred Hutch we value collaboration, compassion, determination, excellence, innovation, integrity and respect. These values are grounded in and expressed through the principles of diversity, equity and inclusion. Our mission is directly tied to the humanity, dignity and inherent value of each employee, patient, community member and supporter. Our commitment to learning across our differences and similarities make us stronger. We seek employees who bring different and innovative ways of seeing the world and solving problems. Fred Hutch is in pursuit of becoming an anti-racist organization. We are committed to ensuring that all candidates hired share our commitment to diversity, anti-racism and inclusion.

The role is responsible for the initiation, monitoring and reconciliation of denied authorization request. This role will coordinate all activity related to the appeals process. This role will interact closely with Fred Hutch medical providers and Revenue Cycle. The Authorization Appeals Coordinator will assist with the development and implementation of action plans for the prevention of denial of authorization requests.

Responsibilities

• Identity, analyze and research root cause for authorization denials.
• Present denial information to Revenue Cycle Management.
• Provide reporting of trends along with supporting documentation.
• Escalation of delays or problems related to appeals.
• Participate in problem solving and process improvement activities.
• Responsible for tracking appeal status and follow up activity.
• Initiates appeals for denied authorization requests.
• Facilitate and/or coordinate peer-to-peer reviews.
• Provide persistent and timely follow up on all related communication and activity.
• Review Electronic Medical Record and extract information in order to document medical necessity.
• Identify opportunities to reduce and prevent authorization denials.

Qualifications

Required:

• Ability to communicate verbally in person, on the phone, and in writing in a clear, concise and professional manner.
• Proficient with the use of Electronic Medical Records.
• High School diploma or equivalent
• Working knowledge of ICD-10, CPT and HCPS coding
• Ability to work independently and as part of a team as the situation requires.
• Minimum of two years patient care coordination, utilization review or similar work experience. Experience should include review and extraction of medical necessity documentation from electronic medical records. In addition, a minimum of one year experience with third-party payor is required.
• Proficient in the use of the MS Office Suite
• Critical thinking
• Ability to troubleshoot and offer solutions for process improvement.
• Ability to apply knowledge of commercial payor and regulatory guidelines
• Medical Terminology
• Ability to organize and prioritize concurrent responsibilities.
• Solid analytical skills.

Preferred

• Associates or Bachelor's degree

A statement describing your commitment and contributions toward greater diversity, equity, inclusion, and antiracism in your career or that will be made through your work at Fred Hutch is requested of all finalists.
This role will have the opportunity to work partially at our campus and remotely.
The hourly pay range for this position is from $26.20 to $37.31 and pay offered will be based on experience and qualifications.  
Fred Hutchinson Cancer Center offers employees a comprehensive benefits package designed to enhance health, well-being, and financial security. Benefits include medical/vision, dental, flexible spending accounts, life, disability, retirement, family life support, employee assistance program, onsite health clinic, tuition reimbursement, paid vacation (12-22 days per year), paid sick leave (12-25 days per year), paid holidays (13 days per year), paid parental leave (up to 4 weeks), and partially paid sabbatical leave (up to 6 months). 
Our Commitment to Diversity
We are proud to be an Equal Employment Opportunity (EEO) and Vietnam Era Veterans Readjustment Assistance Act (VEVRAA) Employer. We are committed to cultivating a workplace in which diverse perspectives and experiences are welcomed and respected. We do not discriminate on the basis of race, color, religion, creed, ancestry, national origin, sex, age, disability (physical or mental), marital or veteran status, genetic information, sexual orientation, gender identity, political ideology, or membership in any other legally protected class. We are an Affirmative Action employer. We encourage individuals with diverse backgrounds to apply and desire priority referrals of protected veterans. If due to a disability you need assistance/and or a reasonable accommodation during the application or recruiting process, please send a request to our Employee Services Center at [email protected] or by calling 206-667-4700.