Insurance Verification Auth Specialist
MultiCare Health System
Tacoma, WA
JOB DETAILS
JOB TYPE
Full-time, Employee
SKILLS
Advance Beneficiary Notice (ABN), Best Practices, Billing, Communication Skills, Current Procedural Terminology (CPT), Customer Support/Service, Documentation, Health Insurance, Healthcare, Healthcare Common Procedure Coding System (HCPCS), Healthcare Providers, Hematology, Insurance, Market Share, Medical Assistance, Medical Billing, Medical Records, Medical Terminology, Oncology, Operational Strategy, Outpatient Care, Patient Care, Patient Care Authorizations, Patient Care Denials, Quality Metrics, Risk Management, Service Delivery, Stewardship, Surgical Procedures, Time Management
LOCATION
Tacoma, WA
POSTED
30+ days ago
At MultiCare, we strive to offer a true sense of belonging for all our employees. Across our health care network, you will find a dynamic range of meaningful careers, opportunities for growth, safe workplaces, and flexible schedules. We are connected by our mission - partnering and healing for a healthy future - and dedicated to the health and well-being of the communities we serve.
FTE: 1.0, Shift: Day, Schedule: Day
Position Summary
The Insurance Verification Auth Specialist is responsible for securing financial clearance and completing pre-authorization for patients undergoing complex, high-dollar inpatient and outpatient surgical procedures, hematology/oncology treatments, and infusion services. This includes verifying insurance eligibility and benefits, validating referrals and prior authorizations, and submitting and monitoring authorization requests in accordance with MultiCare Health System's productivity and quality standards.
The Specialist serves as a key resource on insurance plan guidelines and authorization processes, collaborates with referring providers to resolve pre-service authorization denials, and communicates Advance Beneficiary Notice (ABN) requirements when applicable. This role requires the ability to interpret medical guidelines, payer policies, and benefit structures to ensure accurate financial clearance and support the efficient delivery of specialized healthcare services.
The Specialist also acts as a functional expert across Patient Access and clinical teams, contributing to best practices in financial coordination and patient care access.
Essential Functions
Secure pre-authorizations from insurance companies for a broad range of complex, high dollar healthcare services including inpatient and outpatient surgical procedures, hematology/oncology treatments, and infusion services.
Respond to clinical inquiries through insurance portals to support timely authorization approvals.
Review medical records and supporting documentation to ensure complete and accurate submission for ordered services.
Evaluate and process medical authorization requests efficiently to facilitate uninterrupted patient care.
Communicate effectively with healthcare providers, insurance carriers, and patients to gather and relay information necessary for authorization decisions.
Meet established daily productivity standards to maintain operational efficiency and accuracy in authorization workflows.
Perform essential registration tasks such as loading insurance details, filing orders, and verifying eligibility
Maintain a high level of accuracy to reduce the risk of insurance claim denials and ensure financial clearance for patients.
Serve as a subject matter expert on referrals, authorizations, and insurance plan guidelines within the MultiCare Health System.
Requirements
Minimum two (2) years of experience working complex, high dollar prior-authorizations, referral coordination for relevant service lines, or in insurance billing, admitting, or registration within a healthcare setting
Customer service experience in healthcare
Proficiency in medical terminology, validated by examination
Experience reviewing medical policies and interpreting CPT and HCPCS codes in alignment with payer guidelines
Completion of a health vocational program (e.g., Medical Assistant, Medical Billing & Insurance) preferred
One (1) year of post-secondary business or college coursework preferred
Certification from the National Association of Healthcare Access Management (NAHAM) preferred
Our Values
As a MultiCare employee, we'll rely on you to reflect our core values of Respect, Integrity, Stewardship, Excellence, Collaboration and Kindness. Our values serve as our guiding principles and impact every aspect of our organization, including how we provide patient care and what we expect from each other.
Why MultiCare?
Belonging:We work to create a true sense of belonging for all our employees
Mission-driven:We are dedicated to our mission of partnering for healing and a healthy future and the patients and communities we serve
Market leadership:Washington state's largest community-based, locally governed health system
Employee-centric:Named Forbes "America's Best Employers by State" for several years running
Technology:"Most Wired" health care system 15 years in a row
Leading research:MultiCare Institute for Research & Innovation, 40 years of ground-breaking, clinical and health services research in our communities
Lifestyle:Live and work in the Pacific Northwest - offering breathtaking water, mountains and forest at every turn
Pay and Benefit Expectations
We provide a comprehensive benefits package, including competitive salary, medical, dental and retirement benefits and paid time off. As required by various pay transparency laws, we share a competitive range of compensation for candidates hired into each position. The pay scale is $22.97 - $33.05 USD. However, pay is influenced by factors specific to applicants, including but not limited to: skill set, level of experience, and certification(s) and/or education. If this position is associated with a union contract, pay will be reflective of the appropriate step on the pay scale to which the applicant's years of experience align.
Associated benefit information can be viewed here.
MultiCare is an equal opportunity employer. Hiring decisions are made without regard to race, color, religion, national origin, sexual orientation, gender identity, disability or veteran status. EOE/AA/M/F/D/V
About the Company
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