Remote Prior Authorizations & Referral Coordinator

St. Charles Health System Inc.; Redmond, Northern (OR, KY); Hybrid; USD 30,000 - 41,000; Full time

Job summary

St. Charles Health System is seeking a Prior Authorizations and Referral Management Representative to coordinate pre-authorization and referral workflows across ambulatory services in Redmond, Oregon.

You will liaise between patients, providers, and health plans, ensuring accurate benefit verification and timely authorizations. The role emphasizes scheduling coordination with surgery, specialists, and clinics; you will maintain patient information in the EMR and related systems, educate patients

Qualifications

• Required: High School diploma or GED.
• Preferred: College level coursework.
• Minimum of one year experience in hospital, clinic, or medical insurance billing
• Basic understanding of medical coding

Responsibilities

• Coordinate prior authorization and referral workflows.
• Confirm and validate patient health plan coverage and obtain eligibility.
• Communicate provider, facility, and order information to health plans.
• Assist with patient education and follow up regarding prior authorizations and referrals.
• Schedule coordination with surgery, specialists, and clinics.

Skills

Communication

Organization

Customer service

Multi-tasking

EMR system

Excel

MS Office

MS Teams

Education

High School diploma/GED

College coursework preferred

Tools

MS Office

Excel

MS Teams

EMR system

Job description

St. Charles Health System is seeking a Prior Authorizations and Referral Management Representative to coordinate pre-authorization and referral workflows across ambulatory services in Redmond, Oregon.

You will liaise between patients, providers, and health plans, ensuring accurate benefit verification and timely authorizations. The role emphasizes scheduling coordination with surgery, specialists, and clinics; you will maintain patient information in the EMR and related systems, educate patients