Patient Authorization & Referral Representative

Actalent

Spokane Valley (WA)

On-site

USD 32,000 - 36,000

Part time

3 days ago
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Benefits offered by this job

Medical, dental & vision
401(k) Retirement Plan
Life Insurance
Short/long-term disability
Health Spending Account (HSA)
Transportation benefits
Employee Assistance Program
Paid time off

Job summary

Actalent is seeking a Patient Authorization & Referral Representative for an onsite role in Spokane Valley, WA. The position focuses on verifying insurance benefits, eligibility for referrals, and managing pre-authorizations to support therapy services.

Strong attention to detail and accuracy in documentation are essential. The role requires healthcare setting experience, EPIC or similar EMR familiarity, and excellent communication to coordinate payer interactions and patient information.

Qualifications

  • Proficiency in medical terminology and healthcare terminology.
  • Experience verifying benefits and eligibility for referrals.
  • Experience with prior authorization processes and payer communications.
  • Familiarity with EMR systems, preferably EPIC, and data entry accuracy.

Responsibilities

  • Verify insurance benefits and eligibility for new referrals.
  • Perform monthly Medicaid/DSHS and weekly hospice coverage verifications.
  • Assist in evaluating documentation for therapy coverage eligibility.
  • Gather and ensure completeness of forms and reports.

Skills

Medical terminology
Customer service
Insurance verification
Prior authorization
1+ year experience in healthcare
EPIC or EMR systems

Education

High school diploma or GED

Tools

EPIC EMR

Job description

Job Title: Patient Authorization & Referral RepresentativeJob Description

Responsibilities
  • Verify insurance benefits and eligibility for all new referrals.
  • Perform monthly verification of DSHS coverage for long-term Medicaid patients and weekly verification for capitated Hospice patients.
  • Assist in evaluating documentation to determine if patients meet criteria for therapy coverage.
  • Gather and ensure the accuracy and completeness of forms and reports, addressing any omissions or errors.
  • Create Cost Disclosure/Advance beneficiary notices for Medicare patients and track signed forms.
  • Generate benefits letters to inform patients of financial responsibility.
  • Enter new patient and physician data into the software database, including therapy sessions and ICD-9/ICD-10 codes.
  • Obtain and follow-up on PCP referral requests.
  • Document payer/billing information in patient electronic records.
  • Obtain initial pre-authorizations as required by insurance plans.
  • Verify physician licensure on an ongoing basis.
  • Support the Mission in daily activities.
  • Participate in Quality Assurance and Quality Improvement activities.
  • Perform Medicare Part D eligibility and drug formulary checks.
  • Prepare hospital charity agreements and manage patient financial assistance applications.
Essential Skills
  • Medical terminology
  • Customer service
  • Insurance verification
  • Prior authorization
  • 1+ year experience in a healthcare setting
  • Experience with EPIC or similar EMR systems
Additional Skills & Qualifications
  • One year+ reimbursement experience
  • One year+ verification/insurance benefits experience
  • Ability to type quickly and accurately
  • Effective written and oral communication skills
  • General computer skills, including word processing, spreadsheets, and database software
  • Knowledge of office equipment
  • High school diploma or GED
Work Environment

This position is based in an infusion pharmacy/office setting. The role involves working with various technologies and requires a collaborative team player who is a quick learner, given the dynamic and challenging nature of the work.

Job Type & Location

This is a Contract to Hire position based out of Spokane Valley, WA.

Pay and Benefits

The pay range for this position is $23.00 - $26.00/hr.

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

  • Medical, dental & vision
  • Critical Illness, Accident, and Hospital
  • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
  • Life Insurance (Voluntary Life & AD&D for the employee and dependents)
  • Short and long-term disability
  • Health Spending Account (HSA)
  • Transportation benefits
  • Employee Assistance Program
  • Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type

This is a fully onsite position in Spokane Valley,WA.

Application Deadline

This position is anticipated to close on Oct 7, 2026.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 20,000 consultants and 5,000 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. We are proud to be an Engineering News-Record (ENR) Top 500 Design Firm for our engineering design services and a ClearlyRated Best of Staffing® winner for both client and talent service.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.

San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.

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