Utilization Management Technician

Utilization Management Technician Everett, WA Job Details Contract $25•$26 an hour 1 day ago Benefits Health insurance Dental insurance 401(k) Vision insurance 401(k) matching Qualifications Teamwork Microsoft Excel Microsoft Access Insurance prior authorization Medicare Utilization review Data analysis skills HIPAA Filing Data reporting Mid-level CMS regulatory compliance Analysis skills Data management Utilization management NCQA standards Centers for Medicare and Medicaid Services (CMS) Microsoft Teams Productivity software Phone call management Epic Healthcare data collection Regulatory audits Associate's degree Medical claim denial management Leadership Communication skills Cross-functional communication

Full Job Description Job Title:

Utilization Management Technician Location:

Everett, WA 98201

Work Setting:

Hybrid (Remote + On-site)

On-site Requirement:

2 days/week at

Everett Pacific Campus Schedule:

Monday•Friday (5x8s)

Shift Timing:

Start between 7:00 AM•8:00 AM Position Overview The Utilization Management Technician (Utilization Management Assistant) is responsible for supporting utilization management operations, ensuring compliance with healthcare regulations, and maintaining accurate data reporting. This role involves working closely with payer systems, provider portals, and internal platforms to manage authorizations, denials, and clinical documentation. Key Responsibilities Update and manage payer authorizations Review and work on claim denials Monitor incoming faxes and accurately input data into Epic and Genesis systems Work within provider portals such as Availity Submit clinical documentation to payers in a timely manner Maintain utilization management (UM) data for compliance and reporting Generate and process daily, weekly, and monthly UM reports Maintain organized electronic and paper filing systems Support Health Plan audits, including: Data collection and documentation Preparation for NCQA, DMHC, and CMS audits Assist in compliance tracking and reporting timelines Utilize referral, bed days, and claims databases for reporting and analysis Communicate effectively with internal teams and external stakeholders Answer and screen incoming calls as needed Perform additional duties assigned by the UM Compliance Manager or leadership Required Skills & Qualifications Associate's Degree (Required) Strong experience with Microsoft Office Suite (Word, Excel, Teams, PowerPoint, Access) Hands-on experience with Epic (Required) Familiarity with provider portals such as Availity Knowledge of managed healthcare systems and payer processes Understanding of healthcare regulations:

CMS NCQA DMHC ADA HIPAA

Strong analytical and data management skills Ability to work independently in a remote/hybrid environment Excellent communication and collaboration skills High level of integrity, especially when handling patient financial information

Pay:

$25.00•$26.00 per hour

Benefits:

401(k) 401(k) matching Dental insurance Health insurance Vision insurance

Work Location:

Hybrid remote in Everett, WA 98201