Job ID: 8041
Location: Vancouver, WA
Work Type: Full Time
Shift Length: 8 Hours
Benefit Eligibility: Full-time benefits
PeaceHealth is seeking a Referral/Pre-Auth Specialist for a Full Time, Day position. Hourly compensation starts at $17.61, more depending on experience.
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.
Oversees the data entry and completion of referral forms/notifications. Obtains insurance pre-authorization for patients and re-authorization of additional treatment. Ensures insurance carrier documentation requirements are met and referral support documentation is filed in patient’s medical record.
Efficiently 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 Revenue 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 arena and communicates those changes as appropriate.
Performs other duties as assigned.
See how PeaceHealth is committed to Inclusivity, Respect for Diversity and Cultural Humility.
For full consideration of your skills and abilities, please attach a current resume with your application. EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state or federal laws.