Insurance Verification Auth Specialist

MultiCare Health System

Tacoma, WA

Apply

JOB DETAILS

JOB TYPE

Full-time, Employee

SKILLS

Advance Beneficiary Notice (ABN), Best Practices, Billing, Career Development, Communication Skills, Current Procedural Terminology (CPT), Customer Support/Service, Documentation, Fellowship, Health Insurance, Healthcare, Healthcare Common Procedure Coding System (HCPCS), Healthcare Providers, Hematology, Insurance, 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, Surgical Procedures, Time Management, Tuition Fees

LOCATION

Tacoma, WA

POSTED

30+ days ago

You Belong Here.

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

Why MultiCare?

Rooted in the local community - Partnering with patients, families and neighbors across the Pacific Northwest for more than 140 years

Growth and education - Competitive tuition assistance, award-winning residencies, fellowships and career development to invest in your future

Well-being and support - Generous PTO, Code Lavender and Employee Assistance Programs to help you maintain balance and feel cared for at work and in life

Living our values - Respect, integrity, kindness and collaboration guide how we care for patients, communities and each other

Belonging for all - Employee Resource Groups, inclusion initiatives and outreach programs support a workplace where every voice is valued

Pacific Northwest lifestyle - Work and live where natural beauty, adventure and strong community connections are part of everyday life

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

MultiCare Health System

Resume Resources

Free Resume Templates Free Resume Builder