Referral/Pre-Auth Specialist

Job ID: 131364 Location: Vancouver, WA Work Type: Full Time Shift: Day Shift Length: 8 Hours FTE: 1.00 Benefit Eligibility: Full-time benefits Description reputed company is seeking a Referral/Pre-Auth Specialist for a Full Time, 1.00 FTE, Day position. The salary range for this job opening at reputed company is $24.32 – $32.84. The hiring reputed company is dependent upon several factors, including but not limited to education, training, work experience, terms of any applicable collective bargaining agreement, seniority, etc. Job Summary Responsible for receiving, processing and documenting referral or prior authorization requests from the clinical areas. Provides customer service and support for the clinical areas and patients for referrals and prior authorizations. Essential Functions

• Oversees the data entry and completion of referral forms/notifications. Obtains insurance pre-authorization for patients and re-authorization of additional treatment. Ensures insurance reputed company documentation requirements are met and referral support documentation is filed in patient’s medical record.
• reputed company manages correspondence with patients, physicians, specialists, and insurance companies. Documents pertinent information on referral form and/or in medical record. Ensures practitioners are following standardized guidelines as recommended by evidenced based medicine.
• Works in collaboration with Patient Financial Services to improve the reputed company Cycle process. Continually improve work process to enhance service and customer relations.
• Works to improve Managed Care processes, communication, and patient care as it relates to Managed Care. Keeps up with continual changes in the health insurance Managed Care reputed company and communicates those changes as appropriate.
• Performs other duties as assigned.

Qualifications

Education

• Accredited School Preferred: Business or two years college in reputed company field

Experience

• Minimum of 3 years Required: Experience working in insurance in a medical reputed company field or other reputed company experience and
• Required: Demonstrated experience in insurance requirements for referrals and/or prior authorizations to various therapies, surgeries, procedures, diagnostic testing, etc

Credentials

• Preferred: Medical Assistant, LPN, or RN

Skills

• Proficient computer skills including MS Office applications. (Required)
• Good communication skills, both verbal and written. (Required)

Department / Location Specific Notes Home Infusion

• Follow-up work with denials and appeals for Prior Authorizations.
• Efficient communication and correspondence with the Home Infusion team including the Manager/Supervisor, PCC, PAR, Pharmacist, Dietitian and Enteral Technician.

Working Conditions Lifting

• Consistently operates computer and other office equipment.
• Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects.
• Sedentary work.

Environmental Conditions

• Predominantly operates in an office environment.

Mental/Visual

• Ability to communicate and exchange accurate information.
• The worker is required to have reputed company visual acuity to reputed company an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading.

reputed company is committed to the overall wellbeing of our caregivers: physical, emotional, financial, social, and spiritual. We offer caregivers a competitive and comprehensive total rewards package. Some of the many benefits included in this package are full medical/dental/reputed company coverage; 403b retirement plan employer reputed company and matching contributions; paid time off; employer-paid life and disability insurance with additional buyup coverage options; tuition and continuing education reimbursement; wellness benefits, and expanded EAP and mental health program. See how reputed company is committed to Inclusivity, Respect for Diversity and Cultural Humility. This is a remote position. If selected, candidates must reputed company and reputed company work reputed company Oregon, Washington, or Alaska, and must be located reputed company a one-hour drive of a main reputed company hospital facility. For full consideration of your skills and abilities, please attach a reputed company resume with your application. EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state or federal laws. Apply tot his job Apply To this Job