Pre Service IV Auth Specialist

Position Summary FTE: 1.0, Shift: Day, Schedule: Day Position Summary The Pre-Service IV/Auth Specialist is responsible for completing pre-authorization by patient type and anticipated healthcare service, which includes verifying insurance information (eligibility and benefits), validating referrals and prior authorizations, and submitting and monitoring pre-authorizations while meeting daily productivity and quality standards for the MultiCare Health System. This role acts as a resource regarding front end workflows, authorizations, and insurance plan guidelines; secures financial resources and ensures financial clearance for healthcare services provided to patients; communicates Advance Beneficiary Notice (ABN) issues to referring providers; works with referring providers to resolve pre-service authorization denials; and serves as a functional expert for peers across Patient Access and clinical areas as it relates to financial clearance. This position requires the ability to interpret medical guidelines, benefits, policies, and procedures to ensure financial clearance and the efficient operation of patient healthcare services. Responsibilities Secure pre-authorizations from insurance companies for a broad range of services, including office visits, in-office procedures and injections, diagnostic and advanced imaging studies, and therapy sessions. 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 in pre-authorization, referral coordination, 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. Competitive tuition assistance, award-winning residencies, fellowships and career development to invest in you. Generous PTO, Code Lavender and Employee Assistance Programs to help you maintain balance and feel cared in your work and life. The pay scale is $19.51 - $28.08 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. MultiCare Overview MultiCare is a not-for-profit health care organization with more than 28,000 team members, including employees, providers and volunteers. MultiCare has been caring for our community for well over a century, since the founding of Tacoma’s first hospital and today is the largest community-based, locally governed system of health in the state of Washington, serving communities across Washington and Northern Idaho. MultiCare’s comprehensive system of health includes numerous primary care, urgent care and specialty services — including Mary Bridge Children’s Hospital & Health Network; MultiCare Indigo Urgent Care; Pulse Heart Institute; MultiCare Medical Associates, affiliated physicians; MultiCare Rockwood Clinic, the largest multispecialty clinic in the Inland Northwest region; and MultiCare Connected Care, our Accountable Care Organization. Thirteen hospitals complete the organization: Allenmore Hospital, Auburn Medical Center, Capital Medical Center, Covington Medical Center, Deaconess Hospital, Good Samaritan Hospital, Mary Bridge Children’s Hospital — the Puget Sound region’s only children’s hospital and state-designated Level II Pediatric Trauma Center for Western Washington — Overlake Medical Center, Navos Behavioral Health Hospital, Valley Hospital, Yakima Valley Hospital, Tacoma General Hospital — which is home to the South Puget Sound region’s only Level IV Neonatal Intensive Care Unit — and Wellfound Behavioral Health Hospital. Our core values of Respect, Integrity, Stewardship, Excellence, Collaboration, Kindness and Joy, 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. MultiCare is also proud of our commitment to workforce diversity and culturally competent care. This commitment is led by our CEO and supported through employee education and community outreach. Equal Employment Opportunity 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 View phone number on click.appcast.io 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 MultiCare Health System