Referral and Authorization Specialist

Description

Additional Position Details: FTE: 1.000000 | Full Time | Primarily Monday-Friday/

Starting Wage: $20.5-$28.23 per hour, depending on experience

The Referral and Authorization Specialist is responsible for processing all referrals from 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 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 sending 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 discusses what other possible form of payment may be applicable.

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

We offer a comprehensive Total Rewards package designed to support your well-being and professional growth, including:

• Competitive Pay: Hourly and salaried positions earn market-based compensation.
• Health & Wellness: Medical, dental, and vision coverage for part-time and above employees and their eligible dependents beginning within 30 days of hire.
• Retirement Savings: Employer-sponsored retirement plan with company contribution and match.
• Paid Time Off: Generous ETO for part-time and above employees.
• Professional Development: Continue to enhance your education through our tuition reimbursement and tuition repayment program
• Additional Benefits: Life insurance, disability coverage, and employee assistance programs.

At Asante, we are guided by our values:

Excellence
- Respect
- Honesty
- Service
- Teamwork

Asante is proud to be an Equal Opportunity Employer. We are committed to creating a diverse and inclusive workplace and to employing and advancing qualified individuals of all backgrounds, including women, minorities, individuals with disabilities, and protected veterans.