Insurance Verification Auth Specialist Special Srvc

MultiCare Health System; Oregon; Hybrid; USD 29,000 - 41,000; Full time

Benefits offered by this job

PTO

Code Lavender

Employee Assistance Program

Tuition assistance

Job summary

MultiCare Health System in Oregon seeks an Insurance Verification Auth Specialist to secure financial clearance and pre-authorizations for high-dollar procedures. You'll verify eligibility, handle referrals, and coordinate with providers, payers, and patients to ensure timely and accurate authorizations.

The role emphasizes accuracy, collaboration across teams, and adherence to productivity standards, with day shifts and a comprehensive benefits package.

Qualifications

• Two or more years of experience with complex, high-dollar prior-authorizations.
• Customer service experience in healthcare.
• Proficiency in medical terminology.
• Experience reviewing policies and interpreting CPT/HCPCS codes per payer guidelines.
• Completion of a health vocational program preferred.
• NAHAM certification preferred.

Responsibilities

• Secure pre-authorizations from insurance for complex inpatient/outpatient services.
• Respond to clinical inquiries through insurance portals.
• Review medical records to ensure complete and accurate submissions.
• Evaluate and process authorization requests efficiently.
• Communicate with providers, insurers, and patients for authorization decisions.
• Meet daily productivity standards.
• Perform registration tasks and verify eligibility.
• Maintain accuracy to reduce insurance claim denials.
• Serve as a subject matter expert on referrals and authorizations.

Skills

Insurance verification

Pre-authorization management

Healthcare customer service

Medical terminology

CPT/HCPCS interpretation

Education

Health vocational program completed

NAHAM certification preferred

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: Monday - Friday 8:30am - 5pm

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.

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.