Patient Authorization and Referral Representative

Overview

The Patient Authorization and Referral Representative (PARR) is responsible for the implementation of policies and procedures relating to aspects of the Referral Operations department in Providence Medical Group (primary care and specialty clinics) and performs duties supporting the core functional areas of specialist referral processing, diagnostic authorizations, prior authorization, denials/appeals, and training. The work focuses on department support of activities such as production, service level agreements, strategic outcomes, standards and objectives, and performance improvement activities relevant to Referrals Operations.

The PARR ensures an integrated approach to the program, resulting in timely scheduling of requested services, communication across the continuum of care for requested outpatient services, improvement in the provision of care and services, and improved satisfaction for patients, providers, staff, and external contacts. The PARR functions in a team environment, providing requested services in a centralized setting on behalf of the medical group clinics.

• Support the core functional areas of specialist referral processing, diagnostic authorizations, prior authorization, denials/appeals, and training.
• Assist with production, service level agreements, strategic outcomes, standards and objectives, and performance improvement activities relevant to Referrals Operations.
• Coordinate timely scheduling of requested services and communicate across the continuum of care for outpatient services.
• Collaborate with care teams to improve provision of care and patient satisfaction.
• Operate in a centralized team environment on behalf of Providence Medical Group clinics.

• H.S. Diploma or GED
• 2 years experience in health care industry or related field
• Experience in physician office settings with revenue cycle experience
• Experience in physician or hospital billing and health insurance
• Experience in outpatient ambulatory, clinical quality, and referral management (prior authorization, referrals, appeals, business office or health plans)

• Bachelor's degree or minimum 2 years experience in a healthcare system
• Experience in professional billing revenue cycle management
• Epic software experience
• Experience in database management and spreadsheets

Providence offers a comprehensive benefits package including a retirement 401(k) plan with employer matching, health care benefits (medical, dental, vision), life and disability insurance, time off benefits, voluntary benefits, and well-being resources. Learn more s/benefits.

At Providence, our strength lies in our promise of knowing you, caring for you, and easing your way. We foster an inclusive workplace where diversity is valued and everyone is essential, heard, and respected. Our 120,000 caregivers serve in over 50 hospitals, 1,000+ clinics, and a full range of health and social services across multiple states.

Providence is an Equal Opportunity Employer. We are committed to a workplace free from unlawful discrimination and harassment and maintain a diverse and inclusive environment.

Requisition

Company:
Providence Jobs | Job Category:
Patient Access | Job Function:
Revenue Cycle |

Job Schedule:

Full time |

Job Shift: Day | Career Track:
Admin Support | Department: 5011 PMG N REFERRAL OPS | Address: OR Medford 965 Ellendale |

Work Location:

PMG Medford Medical Clinic-Medford | Workplace Type:
On-site | Pay Range: $18.82 - $28.20

The base pay range is provided; additional compensation may be available for shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.