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Insurance Verification Auth Specialist Special Srvc
MultiCare Health System
Remote, USA
Full-time
Senior · 140+ years experience
Remote
Discovered 6 days ago
Role Overview
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)
Full Job Posting
Responsibilities:
- 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 you.
- Well-being and support
- Generous PTO, Code Lavender and Employee Assistance Programs to help you maintain balance and feel cared in your work and life.
- Living our values
- Respect, integrity, kindness and collaboration guide how we care for patients, communities and each other.
- Belonging for all
- Resource Groups and outreach programs help ensure every team member feels safe, seen, heard and 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 $20.88 - $30.05 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.
Preferred Qualifications
- 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
About MultiCare Health System
Hospitals & Health Systems28000 employeesFounded 1882
A not-for-profit health care system serving the Pacific Northwest.
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