MultiCare
healthcare
InsuranceVerificationAuthSpecialist
Neural analysis suggests this role is
optimal for Mid+ candidates.
“Insurance Verification Auth Specialist at MultiCare. Skills: securing financial clearance, completing pre-authorization, verifying insurance eligibility and benefits, validating referrals and prior authorizations, submitting and monitoring authorization requests. Securing financial clearance. completing pre-authorization for patients undergoing complex, high-dollar inpatient and outpatient surgical procedures, hematology/oncology treatments, and infusion services”
What You'll Achieve.
MultiCare Health System’s productivity and quality standards; accurate financial clearance; support the efficient delivery of specialized healthcare services; best practices in financial coordination and patient care access; timely authorization approvals; complete and accurate submission for ordered services; facilitate uninterrupted patient care; Meet established daily productivity standards; maintain operational efficiency and accuracy in authorization workflows; reduce the risk of insurance claim denials; ensure financial clearance for patients
Industry & Context.
resolve pre-service authorization denials
What They're Looking For.
Must Have
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
Nice to Have
Completion of a health vocational program (e. g. , Medical Assistant, Medical Billing & Insurance), One (1) year of post-secondary business or college coursework, Certification from the National Association of Healthcare Access Management (NAHAM)
What You'll Do.
Securing financial clearance
completing pre-authorization for patients undergoing complex
high-dollar inpatient and outpatient surgical procedures
hematology/oncology treatments
and infusion services
verifying insurance eligibility and benefits
validating referrals and prior authorizations
submitting and monitoring authorization requests
interpreting medical guidelines
and benefit structures
communicating Advance Beneficiary Notice (ABN) requirements
acting as a functional expert across Patient Access and clinical teams
securing pre-authorizations from insurance companies for a broad range of complex
high dollar healthcare services
responding to clinical inquiries through insurance portals
reviewing medical records and supporting documentation
evaluating and processing medical authorization requests
communicating effectively with healthcare providers
performing essential registration tasks such as loading insurance details
and verifying eligibility
How You'll Work.
Team & Collaboration
collaborates with referring providers to resolve pre-service authorization denials; serves as a functional expert across Patient Access and clinical teams; communicates effectively with healthcare providers, insurance carriers, and patients
Communication Scope
Communicate effectively with healthcare providers, insurance carriers, and patients to gather and relay information necessary for authorization decisions.
Full Job Description
**Join a team that shares your calling** At MultiCare, you’re more than just a job title — you’re part of a team built on trust that cares for each other, our patients and our communities. Belonging here means living our mission and values every day. If your purpose and passions align with ours, you’ll find a place to grow, do meaningful work and build a career you love in a community that feels like home. **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 med
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