Prior Authorization & Referral Specialist

St. Charles Health System; Bend (OR); On-site; USD 42,000 - 54,000; Full time

Job summary

St. Charles Health System is seeking a Prior Authorizations and Referral Management Representative to coordinate authorizations and referrals for services, tests, and surgeries. You will liaise between patients and staff, facilitating care coordination and scheduling across departments.

The role requires multitasking, attention to benefits eligibility, and accurate system updates. Experience in medical billing or related fields is preferred, with emphasis on teamwork and patient-centered service.

Qualifications

• High school diploma or GED required; college coursework preferred.
• Minimum one year experience in hospital, clinic, or medical insurance billing office.
• Basic understanding of medical coding.

Responsibilities

• Coordinate prior authorization and referral processes for tests, procedures, and surgeries.
• Communicate with providers, facilities, and health plans regarding authorizations and scheduling.
• Update systems with current authorization and referral information.
• Assist with patient education and follow-up on authorization statuses.
• Schedule patients with internal and external departments and ensure timely processing.

Skills

Multitasking

Care coordination

Provider communication

Scheduling coordination

Customer service

Professionalism

Confidentiality

Team collaboration

Education

High School diploma or GED

College level coursework (preferred)

Job description

St. Charles Health System is seeking a Prior Authorizations and Referral Management Representative to coordinate authorizations and referrals for services, tests, and surgeries. You will liaise between patients and staff, facilitating care coordination and scheduling across departments.

The role requires multitasking, attention to benefits eligibility, and accurate system updates. Experience in medical billing or related fields is preferred, with emphasis on teamwork and patient-centered service.