Care Access & Authorization Specialist

Praxis Health; Bend (OR); On-site; USD 53,726,000 - 57,859,000; Full time

Benefits offered by this job

Medical/Dental/Vision

401K match

Paid Time Off

In-house lab testing

Job summary

Praxis Health seeks a detail-oriented Referral & Authorization Specialist to coordinate patient referrals and manage prior authorizations for medications, imaging, procedures, and specialty services. You will review orders, verify insurance requirements, submit requests, and track progress to ensure timely access to care.

You will work with providers, clinical staff, insurers, pharmacies, and outside facilities, maintaining accurate documentation and prioritizing high-volume workloads while

Qualifications

• 2+ years of healthcare experience, esp. referrals, prior authorizations, medical billing, insurance verification.
• Knowledge of health insurance plans, referral requirements, prior authorization processes, and payer guidelines.
• Experience with EHR and practice management systems; familiarity with medical terminology and HIPAA confidentiality.

Responsibilities

• Process and coordinate referrals and prior authorizations for specialty care, imaging, procedures, medications, and other services.
• Review patient insurance coverage to determine referral and authorization requirements, network restrictions, and payer guidelines.
• Submit referrals and prior authorization requests through payer portals, electronic systems, phone or fax as required.
• Review orders and documentation for completeness and obtain additional info from clinical staff.
• Maintain documentation of referral/authorization activities in the EHR or practice management system.

Skills

Referral processing

Prior authorizations

Insurance verification

Attention to detail

Time management

HIPAA compliance

Education

Healthcare admin degree

Tools

EHR systems

Practice management systems

Insurance payer portals

Job description

Praxis Health seeks a detail-oriented Referral & Authorization Specialist to coordinate patient referrals and manage prior authorizations for medications, imaging, procedures, and specialty services. You will review orders, verify insurance requirements, submit requests, and track progress to ensure timely access to care.

You will work with providers, clinical staff, insurers, pharmacies, and outside facilities, maintaining accurate documentation and prioritizing high-volume workloads while