MultiCare Health System
Insurance Verification Auth Specialist
MultiCare Health System, Mission, Texas, United States, 78512
Insurance Verification Auth Specialist page is loaded## Insurance Verification Auth Specialistlocations:
Remote, USAtime type:
Full timeposted on:
Posted Todayjob requisition id:
JR62064**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**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.* **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 .MultiCare provides equal employment opportunity to all employees and job applicants. We do not tolerate discrimination or harassment based on race, color, religion, age, sex, national origin, disability status, genetic information, protected veteran status, sexual orientation, gender identity or expression or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.If you are an external job applicant who requires reasonable accommodation in the job application process, please contact the Employee Resource Center (ERC) at 253-403-6947 and we will assist you with submitting a ticket to initiate your request for accommodation. If you are a current employee, you can submit an ERC ticket or call the ERC for assistance. #J-18808-Ljbffr
Remote, USAtime type:
Full timeposted on:
Posted Todayjob requisition id:
JR62064**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**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.* **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 .MultiCare provides equal employment opportunity to all employees and job applicants. We do not tolerate discrimination or harassment based on race, color, religion, age, sex, national origin, disability status, genetic information, protected veteran status, sexual orientation, gender identity or expression or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.If you are an external job applicant who requires reasonable accommodation in the job application process, please contact the Employee Resource Center (ERC) at 253-403-6947 and we will assist you with submitting a ticket to initiate your request for accommodation. If you are a current employee, you can submit an ERC ticket or call the ERC for assistance. #J-18808-Ljbffr