Utilization Management Insurance Verification and Authorization Specialist
MultiCare Health System
Location: Tacoma, Washington
Internal Number: 103205
The reasons to work at MultiCare are as unique as the people who do. Join us for the professional challenges you seek. In the settings you prefer. With schedules that fit your life. Learn more at www.multicarejobs.org
Position Summary: The Utilization Management Insurance Verification and Authorization Specialist contacts/notifies a vast array of insurance carriers of hospital admissions per contract requirements to ensure that patients health care benefits cover required procedures and admissions. The incumbent verifies insurance information (eligibility, benefits and coverage levels); submitts and monitors authorizations; identifies and organizes financial resources for anticipated healthcare charges; completes prior authorization of direct admission as required by patient type and anticipated service; provides estimate of patient liabilities; works with individuals to educate them on their benefits information using exceptional customer service skills. Incumbents work with staff and management throughout the revenue cycle, as well as representatives from insurance carriers and government agencies.
Minimum Requirements: One of the following: One (1) year of pre-authorization or referral coordinator experience to include pre-authorization request for an insurance payor OR Two (2) years admitting, or registration experience in a hospital or medical office OR Graduate of a health vocational program such as Medical Assistant, or Medical Billing & Insurance, and 1 year experience in healthcare AND: Two (2) years experience in dealing with the public in a customer service role Medical Terminology proficiency by examination One (1) year of post high school business or college course work preferred
Education/Licenses/Certifications: National Association of Healthcare Access Management Certification (NAHAM) preferred
MultiCare is a not-for-profit health care organization with more than 20,000 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.
Eleven 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 Washingt...on — Navos Behavioral Health Hospital, 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 and Kindness, 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.