Who we are Community Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to any act…
Skills: Data Entry, Medical Terminology, CPT Coding, HCPC Coding, ICD-10 Coding
A Patient Care Coordinator provides a variety of receptionist and skilled clerical duties in support of the clinics. This position is responsible for scheduling patients, obtaining necessary documentation and coordinatin…
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Our Merchandisers play a pivotal role at Columbia Distributing. Over the course of distribution, Merchandising is the final stop in getting beverages into our customer's hands. After the Delivery team delivers product to…
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Part Time (30 Hours) Associate Banker, Chehalis Branch, Chehalis, OR
Chehalis, Washington, United States · On-site
$22/hr–$27/hr
Entry level$1.6B raised
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Skills: Client Service, Relationship Building, Communication, Problem Solving, Attention to Detail
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McCurley Dealerships have a high-trust culture that attracts, retains, engages, and inspires people. Our culture consistently exceeds customer expectations by providing world-class service. We partner with our community …
Skills: Automotive Part Sales, Electronic Catalogs, Customer Service, Organization, Efficiency
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Battle Ground, Washington, United States · On-site
Mid level
Benefits: 401(k) Bonus based on performance Dental insurance Employee discounts Flexible schedule Health insurance Training & development Vision insurance 401(k) matching Free uniforms Paid time off Wellness resources Pa…
Benefits: 401(k) Bonus based on performance Dental insurance Employee discounts Flexible schedule Health insurance Training & development Vision insurance 401(k) matching Free uniforms Paid time off Wellness resources Pa…
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Skills: Sales, Customer Service, Cash Handling, Communication Skills, Goal Setting
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Pierce County, Washington, United States · On-site
Mid level
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Responsible for administrative functions in processing Utilization Management determinations, including data entry for authorizations and hospital notifications. The role involves validating benefits, reviewing denial letters for accuracy, and coordinating with clinical staff and providers.
Requirements
Requires an associate degree or equivalent experience, with a preference for one year of customer service and experience in healthcare or managed care settings. Candidates must be knowledgeable in medical terminology and pass a criminal background check.
Full job description
Who we are
Community Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to any actual or perceived protected characteristic or other unlawful consideration.
Our commitment is to:
Strive to apply an equity lens to all our work.
Reduce health disparities.
Create an equitable work environment.
About the Role:
The level I UM Coordinator is responsible for administrative functions in processing Utilization Management (UM) organization determinations for services requiring authorization and hospital notification. Utilizing knowledge of Medicare and Medicaid guidelines to facilitate and comply with the UM processes in data entry of authorization requests, eligibility verification, benefit determinations, timely letter fulfilment, and support to UM clinical staff.
To be successful in this role, you:
Have an associate degree, or an equivalent combination of education and highly relevant experience.
Have at least one (1) year of customer service experience, preferred.
Have working experience in a Healthcare setting, preferred.
Have working experience in a Managed Care setting, preferred.
Are knowledgeable of medical terminology and healthcare processes, preferred.
Are knowledgeable of Washington Apple Health and Medicare Advantage Plans, preferred.
Essential functions and Roles and Responsibilities:
Performs data entry for all referral, prior authorizations and hospital notifications; attaches and/or includes clinical documents as needed.
Utilizes knowledge to determine appropriate CPT, HCPC, ICD-10 codes using CMS, NCQA and HCA criteria.
Researches and validates benefit and prior authorization requirements to determine appropriate course of action within the Care Management system.
Reviews, corrects, and approves authorization requests via the web portal; determines appropriate level of complexity and refers cases requiring clinical review to a nurse reviewer.
Reviews completed denial letters for accuracy and adherence to compliance deadlines. Edits and proofreads content for appropriate medical terminology and MCG criteria. Ensures letters are mailed within established timeframes.
Accurately applies policies & procedures, benefit and eligibility standards to all incoming requests.
Conducts research, validates data, and responds to complex inquiries from multiple sources, including but not limited to members, nurses, medical providers, customer service, operations, appeals, case management and care coordination. Escalating issues as needed.
Reporting to work on time and for all scheduled shifts is essential to this position.
Other duties as assigned. Essential functions listed are not necessarily exhaustive and may be revised by the employer, at its sole discretion.
Knowledge, Skills, and Abilities:
Solid analytical skills and the ability to interpret, evaluate and formulate action plans based upon data.
Knowledge of care management workflow systems.
Effective verbal and written communication skills. Able to communicate with and collaborate effectively with physicians and allied health care providers.
Flexibility and willingness to work in a matrix-management environment.
Demonstrated organizational, time management, and project management skills.
Ability to multi-task and deal with complex assignments on a frequent basis.
Demonstrated proficiency and experience with Microsoft Office products.
Ability to work independently.
Collaborate with others in a respectful manner and ability to maintain confidentiality.
Perform all functions of the job with accuracy, attention to detail and within established timeframes.
As part of our hiring process, the following criteria must be met:
Complete and successfully pass a criminal background check
Criminal History: includes review of criminal convictions and probation. CHPW does not automatically or categorically exclude persons with a criminal background from employment. The applicant’s criminal history will be reviewed on a case-by-case basis considering the risk to the business, members, and/employees.
Has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency
Vaccination requirement (CHPW offers a process for medical or religious exemptions)
Candidates whose disabilities make them unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation.
Compensation and Benefits:
The position is FLSA Non-Exempt and is not eligible for overtime. Based on market data, this position grade is 38 (see full range below) and has a 5% annual incentive target based on company, department, and individual performance goals.
CHPW offers the following benefits for Full and Part-time employees and their dependents:
Medical, Prescription, Dental, and Vision
Telehealth app
Flexible Spending Accounts, Health Savings Accounts
Basic Life AD&D, Short and Long-Term Disability
Voluntary Life, Critical Care, and Long-Term Care Insurance
401(k) Retirement and generous employer match
Employee Assistance Program and Mental Fitness app
Financial Coaching, Identity Theft Protection
Time off including PTO accrual starting at 17 days per year.
40 hours Community Service volunteer time
10 standard holidays, 2 floating holidays
Compassion time off, jury duty
Sensory/Physical/Mental Requirements:
Sensory*:
Speaking, hearing, near vision, far vision, depth perception, peripheral vision, touch, smell, and balance.
Physical*:
Extended periods of sitting, computer use, talking and possibly standing
Frequent torso/back static position; occasional stooping, bending, and twisting.
Some kneeling, pushing, pulling, lifting, and carrying (not over 25 pounds), twisting, and reaching.
Mental:
Ability to learn and prioritize multiple tasks at a given time and have the capability of handling demanding situations. Analytical/problem solving/critical thinking ability.
Work Environment:
Office environment Employees who frequently work in front of computer monitors are at risk for environmental exposure to low-grade radiation.
We are a not-for-profit offering Medicaid, Medicare Advantage, and Individual & Family health plans in Washington state.
Industry
Insurance
Company size
501-1,000 employees
Founded
1992
Headquarters
Seattle, WA
LinkedIn followers
8,196
For over 30 years, Community Health Plan of Washington (CHPW) has been providing quality health care to Washington families and supporting your choices for health care.
You’re the expert on your health and well-being. Our mission is to support you in making the best health care decisions for you and your family.
Committed to leading the way
We’re Washington’s first not-for-profit to serve Apple Health members.
In 1992, Washington’s low-cost clinics (known as Community Health Centers) realized too many people were being neglected by traditional insurance. They got together and started Community Health Plan of Washington.
CHPW is the state’s first not-for-profit managed care plan founded by Community Health Centers.
Today, we’re still the only not-for-profit to provide managed care to Apple Health members.
Always working to improve our services, we expanded to cover Medicare patients in 2007.
Committed to Washington's families
We treat you how we’d want to be treated.
We strive to make CHPW a home for all our members. Home means different things to different people, but it starts with being understood, respected, and cared for.
Juggling your family’s health care needs can feel like a full-time job. But we’re on your team, helping you access all the services, therapies and solutions you need for their whole health. No matter what language a member speaks, we offer translation services.
We provide access to high-quality medical services for everyone, regardless of ability to pay.
Together, with our family of Community Health Centers, we empower members with services that go beyond traditional health care (like food, housing, and transportation assistance).
Committed to Washington's communities
We're here for Washington's residents, because we are Washington residents.
You’ll see us around Washington at your community events, on the bus, or even at the PTA meeting. Our CHPW staff are your neighbors here in Washington.
Offices: 1111 Third Avenue, Suite 400, Seattle, WA 98101, US
Health InsuranceManaged Care ServicesMedical ManagementMedicareand MedicaidHealth CareNon ProfitMedical
How much do Customer Service & Support jobs in Washington pay?
Based on 1777 listings with disclosed salaries, most customer service & support jobs in Washington pay between $54k–$145k per year. Individual offers vary with seniority, company size, and specialization.
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There are currently 15,295 open customer service & support positions in Washington listed on Clera. New openings are added daily as companies post roles.
Which companies are hiring for Customer Service & Support roles in Washington?
Companies currently hiring include Domino's, Albertsons Companies, Starbucks, Kroger, Costco Wholesale, among others. Browse the listings above to see every active employer.
Are there remote or hybrid Customer Service & Support jobs in Washington?
Yes — 853 of the 15295 open customer service & support positions offer remote or hybrid work (365 remote, 488 hybrid).
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