Prior Authorization & Referral Coordination Specialist

St. Charles Health System Inc.; Bend (OR); Hybrid; USD 42,000 - 64,000; Full time

Job summary

St. Charles Health System in Bend, Oregon seeks a diligent Prior Authorizations and Referral Management Representative to coordinate pre-authorization and referrals for services and surgery. You will liaise between patients, providers, and health plans, handling scheduling and documentation with accuracy.

The role emphasizes strong communication, organizational skills, and teamwork within a care team, supporting efficient patient flow and access to care in a fast-paced ambulatory setting.

Qualifications

• One year experience in hospital, clinic, or medical insurance billing office, performing duties related to medical billing, pre-authorization, claims processing, or related area.
• Basic understanding of medical coding.
• Excellent communication and organizational skills.

Responsibilities

• Coordinate prior authorizations and referrals for services.
• Verify patient health plan coverage and benefits.
• Schedule patients with departments and clinics.
• Communicate with providers, care team members and health plans regarding authorizations and scheduling.
• Maintain accurate documentation in EMR and related systems.
• Assist with patient education and follow-up regarding authorizations and referrals.

Skills

Communication

Organizational skills

Customer service

Multitasking

Teamwork

Telephone etiquette

Analytical skills

Attention to detail

Education

High School diploma or GED

College coursework

Tools

EMR system

Excel

MS Office

MS Teams

Job description

St. Charles Health System in Bend, Oregon seeks a diligent Prior Authorizations and Referral Management Representative to coordinate pre-authorization and referrals for services and surgery. You will liaise between patients, providers, and health plans, handling scheduling and documentation with accuracy.

The role emphasizes strong communication, organizational skills, and teamwork within a care team, supporting efficient patient flow and access to care in a fast-paced ambulatory setting.