Prior Authorization & Referral Management Specialist

stcharles; Bend (OR); On-site; USD 29,000 - 40,000; Full time

Job summary

ST. CHARLES HEALTH SYSTEM in Bend, Oregon seeks a Prior Authorizations and Referral Management Representative in Ambulatory Access Services.

This full-time role coordinates prior authorizations and referrals for tests, procedures, and surgeries, acting as liaison between patients and providers to ensure smooth care coordination. The position requires multitasking, strong communication with health plans, and collaboration with care teams to verify coverage and eligibility.

Qualifications

• High School diploma or GED required.
• College-level coursework preferred.

Responsibilities

• Coordinate prior authorization and referral processes for patients referred for services, tests, or surgeries.
• Multitask and prioritize workflows; engage providers, care team, and patients in the prior authorization process.
• Communicate provider, facility, and order information to health plans; obtain accurate benefit eligibility.
• Coordinate patient assistance programs and scheduling with surgery departments, specialists, and clinics.

Education

High School diploma or GED

Job description

ST. CHARLES HEALTH SYSTEM in Bend, Oregon seeks a Prior Authorizations and Referral Management Representative in Ambulatory Access Services.

This full-time role coordinates prior authorizations and referrals for tests, procedures, and surgeries, acting as liaison between patients and providers to ensure smooth care coordination. The position requires multitasking, strong communication with health plans, and collaboration with care teams to verify coverage and eligibility.