Referral & Authorization Specialist — Elevate Patient Access

Socket.dev; Bend (OR); On-site; USD 52,000 - 64,000; Full time

Benefits offered by this job

Medical, Dental, Vision

401(k) with discretionary employer-mat

Paid Time Off

Free diagnostic laboratory testing

Job summary

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

Ideal candidates have healthcare experience, strong knowledge of payer guidelines, and excellent attention to detail for high-volume workloads within an ambulatory setting.

Qualifications

• 2+ years of healthcare experience preferred, especially in referrals and prior authorizations.

Responsibilities

• Process and coordinate referrals and prior authorizations for specialty care, imaging, procedures, medications, and other services.
• Review insurance requirements, payer guidelines, and network restrictions.
• Submit referrals and prior authorization requests via payer portals, electronic systems, phone or fax.
• Review orders and clinical documentation for completeness and obtain missing information.
• Gather documentation (chart notes, results, insurance data) as needed.
• Communicate with providers, payers, pharmacies, and facilities to resolve issues.
• Track pending referrals/authorizations and follow up with payers to ensure timely processing.
• Document approvals, denials, and additional information requests.
• Redirect referrals or services when needed due to network or patient factors.
• Maintain accurate documentation in EHR/practice management systems.
• Inform clinical teams about authorization/referral status and requirements.
• Keep up-to-date with payer policies and workflow changes.
• Prioritize workload based on urgency and departmental procedures.
• Follow established workflows for consistent processing.

Skills

Referral processing

Prior authorization

Insurance verification

Medical terminology

Documentation accuracy

Time management

Communication

HIPAA compliance

Prioritization

Education

Associate’s or Bachelor’s degree in healthcare administration/health information management/medical assisting or related field

Tools

EHR systems

Practice management systems

Insurance/payer portals

Job description

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

Ideal candidates have healthcare experience, strong knowledge of payer guidelines, and excellent attention to detail for high-volume workloads within an ambulatory setting.