Referral/Pre-Auth Specialist

PeaceHealth

Vancouver, WA(remote)

JOB DETAILS
SALARY
$24.32–$32.84 Per Hour
SKILLS
Communication Skills, Hospital, Insurance, Multitasking, Organizational Skills, Patient Care, Patient Care Denials, Problem Solving Skills, Team Player, Work From Home
LOCATION
Vancouver, WA
POSTED
2 days ago
**Description** **PeaceHealth | PFS Referrals & Eligibility** **Full-Time (1.0 FTE) | Day Shift | Remote (OR, WA, AK only)** **Pay Range: $24.32 - $32.84/hr** _The hiring rate is dependent upon several factors, including but not limited to education, training, work experience, terms of any applicable collective bargaining agreement, seniority, etc._ **Location requirement** This is a remote role. You **must** live and work in Oregon, Washington, or Alaska and be within a 1-hour drive of a PeaceHealth hospital. **Why this role, why now** If you've ever felt like referral work is all volume, constant queues, and little connection to the patient, this role is built differently. · Be the difference-maker behind patient access. Your work directly clears the path for care, getting patients to treatment faster, with fewer barriers. · Less churn, more ownership. You'll manage referrals end-to-end, not just pass them along. · Remote work with real connection. Work from home while staying tied to a local PeaceHealth hospital and care teams. · Join a system investing in access now. We're actively improving how patients move through care, and referrals are central to that change. · Feel your impact daily. You'll see how your work reduces delays, denials, and patient anxiety. **What you'll do (no jargon, just real work)** · Review referral and prior authorization requests and make sure nothing is missing. · Contact insurance providers to secure approvals for procedures, tests, and treatments. · Follow each case through, not just submitting, but making sure it gets completed. · Talk with patients when needed so they understand what's happening and what to expect. · Coordinate with providers, clinics, and specialists to ensure referrals move smoothly. · Track updates, decisions, and important details clearly in the patient record. · Stay current on insurance rules and adjust quickly when requirements change. · Step in to resolve denials or delays so care doesn't stall. **Success Matrix: What great looks like here** In this role, success isn't about how many referrals you touch, it's about what happens because you did. · Patients get scheduled sooner because approvals are handled right the first time · Fewer denials due to complete, accurate submissions · Patients feel informed instead of confused about their care journey · Providers trust that referrals won't fall through the cracks · Care moves forward without unnecessary delays **What you bring (Qualifications)** · 2-3+ years of direct experience verifying and submitting referrals and/or prior authorizations · A clear understanding of the difference between a referral and a prior authorization · Ability to manage multiple priorities while staying organized and accurate · Strong organizational skills with the ability to quickly locate and recall information · Clear, professional communication and comfort receiving ongoing feedback · Experience working with insurance requirements across procedures, therapies, or diagnostics · Comfort navigating multiple systems and working independently in a remote environment · A dedicated workspace with minimal distractions during working hours **Nice to have (but not required)** · Strong critical thinking skills and the ability to problem-solve through complex cases · Experience working both independently and collaboratively, with a mindset that values teamwork and shared success · Patience and adaptability when working with diverse patients, providers, and teammates **Our culture at PeaceHealth** At PeaceHealth, we believe behind every referral is a real person waiting for care. That perspective shapes how we work, with empathy, collaboration, and respect. + People-first mindset; for patients _and_ caregivers + Inclusive environment where different backgrounds and perspectives are respected and welcomed + Supportive teams that value communication, feedback, and shared accountability + Mission-driven work rooted in compassionate care for our communities We care about your whole well-being, physical, emotional, financial, and spiritual, and offer a comprehensive benefits package including medical, dental, vision, retirement contributions, paid time off, and mental health support. See how PeaceHealth is committed to Inclusivity, Respect for Diversity and Cultural Humility (https://www.thecaregiver.org/wp-content/uploads/2017/05/PeaceHealth-Statement-of-Commitment-to-Diversity-and-Inclusion-vFINAL.pdf) . REQNUMBER: 131364

About the Company

P

PeaceHealth

INDUSTRY
Other/Not Classified