Referral/Pre-Auth Specialist

PeaceHealth Corporation; Vancouver (WA); Remote; USD 34,000 - 45,000; Full time

Job summary

PeaceHealth is seeking a Referral/Pre-Auth Specialist for a fully remote role. You will review referral and prior authorization requests, contact insurance providers for approvals, and guide cases through to completion with accuracy and empathy.

This position supports patient access and care coordination within PeaceHealth’s PFS Referrals & Eligibility team, with a focus on timely approvals, clear patient communication, and collaboration with providers and care teams.

Qualifications

• 2–3+ years of direct experience verifying and submitting referrals and/or prior authorizations in a medical setting.
• Clear understanding of the difference between a referral and a prior authorization.
• Ability to manage multiple priorities while staying organized and accurate.
• Experience working with insurance requirements across procedures, therapies, or diagnostics.
• Comfort navigating multiple systems and working independently in a remote environment.

Responsibilities

• Review referral and prior authorization requests and ensure nothing is missing.
• Contact insurance providers to secure approvals for procedures, tests, and treatments.
• Follow each case through to completion, not just submission.
• Talk with patients when needed to explain what’s happening and what to expect.
• Coordinate with providers, clinics, and specialists to move referrals smoothly.
• Track updates, decisions, and important details in the patient record.
• Stay current on insurance rules and adjust quickly when requirements change.
• Step in to resolve denials or delays so care doesn’t stall.

Skills

Referral submissions

Prior authorizations

Insurance knowledge

Remote work

Job description

Referral/Pre-Auth Specialist

Pay Range: $24.32 – $32.84/hr

The hiring rate is dependent upon several factors, including but not limited to education, training, work experience, terms of any applicable collective bargaining agreement, seniority, etc.

Location requirement

This is a remote role. You

Description

Job Description

Referral/Pre-Auth Specialist

PeaceHealth | PFS Referrals & Eligibility

Full-Time (1.0 FTE) | Day Shift | Remote (OR, WA, AK only)

Pay Range: $24.32 – $32.84/hr

The hiring rate is dependent upon several factors, including but not limited to education, training, work experience, terms of any applicable collective bargaining agreement, seniority, etc.

Location requirement

This is a remote role. You must live and work in Oregon, Washington, or Alaska and be within a 1-hour drive of a PeaceHealth hospital.

Why this role, why now

If you’ve ever felt like referral work is all volume, constant queues, and little connection to the patient, this role is built differently.

• Be the difference-maker behind patient access. Your work directly clears the path for care, getting patients to treatment faster, with fewer barriers.
• Less churn, more ownership. You’ll manage referrals end-to-end, not just pass them along.
• Remote work with real connection. Work from home while staying tied to a local PeaceHealth hospital and care teams.
• Join a system investing in access now. We’re actively improving how patients move through care, and referrals are central to that change.
• Feel your impact daily. You’ll see how your work reduces delays, denials, and patient anxiety.

What You’ll Do

• Review referral and prior authorization requests and make sure nothing is missing.
• Contact insurance providers to secure approvals for procedures, tests, and treatments.
• Follow each case through, not just submitting, but making sure it gets completed.
• Talk with patients when needed so they understand what’s happening and what to expect.
• Coordinate with providers, clinics, and specialists to ensure referrals move smoothly.
• Track updates, decisions, and important details clearly in the patient record.
• Stay current on insurance rules and adjust quickly when requirements change.
• Step in to resolve denials or delays so care doesn’t stall.

Success Matrix: What great looks like here

In this role, success isn’t about how many referrals you touch, it’s about what happens because you did.

• Patients get scheduled sooner because approvals are handled right the first time
• Fewer denials due to complete, accurate submissions
• Patients feel informed instead of confused about their care journey
• Providers trust that referrals won’t fall through the cracks
• Care moves forward without unnecessary delays

What You Bring (Qualifications)

• Required: 2–3+ years of direct experience verifying and submitting referrals and/or prior authorizations in a medical setting
• A clear understanding of the difference between a referral and a prior authorization
• Ability to manage multiple priorities while staying organized and accurate
• Strong organizational skills with the ability to quickly locate and recall information
• Clear, professional communication and comfort receiving ongoing feedback
• Experience working with insurance requirements across procedures, therapies, or diagnostics
• Comfort navigating multiple systems and working independently in a remote environment
• A dedicated workspace with minimal distractions during working hours

Nice to have

• Strong critical thinking skills and the ability to problem-solve through complex cases
• Experience working both independently and collaboratively, with a mindset that values teamwork and shared success
• Patience and adaptability when working with diverse patients, providers, and teammates

Our culture at PeaceHealth

At PeaceHealth, we believe behind every referral is a real person waiting for care. That perspective shapes how we work, with empathy, collaboration, and respect.

• People-first mindset; for patients and caregivers
• Inclusive environment where different backgrounds and perspectives are respected and welcomed
• Supportive teams that value communication, feedback, and shared accountability
• Mission-driven work rooted in compassionate care for our communities

About PeaceHealth's Benefits

PeaceHealth is committed to the overall wellbeing of our caregivers: physical, emotional, financial, social, and spiritual. We offer a competitive and comprehensive benefits package that includes:

• Medical, dental, and vision coverage
• 403(b) retirement plan with employer contributions and matching opportunities
• Generous paid time off
• Employer-paid life and disability insurance
• Optional supplemental insurance coverage
• Tuition reimbursement and continuing education support
• Wellness resources and programs
• Expanded Employee Assistance Program (EAP)
• Mental health support resources

We care about your whole well-being, physical, emotional, financial, and spiritual, and offer a comprehensive benefits package including medical, dental, vision, retirement contributions, paid time off, and mental health support.

See how PeaceHealth is committed to .