Job Details

Additional Position Details: FTE: 1.000000 | Full Time | 1st Shift - Days

Starting Wage: $20.53-$28.23 per hour, depending on experience

Position Summary

The Referral and Authorization Specialist is responsible for processing all referrals from the assigned area of specialty. This includes securing pre-authorizations when necessary to facilitate timely appointments and support continuity of care within the health system.

As a Referral and Authorization Specialist for Asante, you will have the opportunity to:

• Receive and transcribe all referrals in Asante's referral tracking system, assist with coordinating the scheduling of care based on clinical protocols, and send confirmation for scheduled services to the patient.
• Ensure patient demographic and insurance information accompanying the referral is accurate and complete, and follow up with referring clinics and/or patients as needed to fill in missing or incorrect information.
• Obtain pre-authorizations and pre-certifications from third-party payers in accordance with payer requirements and document the authorization number and period of validity in the referral.
• Gather additional medical records from other providers as needed to support medical necessity when obtaining a preauthorization, and follow up with payers on pre-authorization requests as needed.
• Identify patients who will need to receive Medicare Advance Beneficiary Notices of Noncoverage, along with Waivers for Oregon Health Plan and Commercial insurance patients.
• Accurately enter all referral information into appropriate systems daily in order to schedule the initial evaluation and follow-up appointments as needed.
• Ensure Therapists have all clinical information necessary for referral appointments & authorization forms, and send any additional documents upon request.
• Alert the therapist involved in the patient's care when there are issues with referrals or complications with insurance coverage.
• Inform the patient whether the authorization for the referral has been approved or denied, and discuss what other possible form of payment may be applicable.

Qualifications

• Minimum of 2 years of healthcare-related insurance, scheduling, front desk, or comparable experience, required
• Associate Degree in business or healthcare-related field, preferred
• CHAA: Certified Healthcare Access Associate, preferred

Total Rewards Package

• Earn a competitive and progressive salary
• Benefit from health plans that are focused on health and wellness, including medical, dental, vision, and wellness, beginning within 30 days of hire
• On-call employees may receive an additional 15% for flexibility
• Plan for your future with a retirement package that includes up to 6% employer contribution
• Experience a healthy work-life balance with our generous earned time off (ETO)
• Continue to enhance your education through our tuition reimbursement and tuition repayment plans

At Asante, we are guided by our values below. Explore Asante more by visiting www.asante.org/careers

Excellence - Respect - Honesty - Service - Teamwork

Asante is an equal opportunity employer. We are committed to employ and advance in employment women, minorities, qualified individuals with disabilities and protected veterans.