Senior Patient Authorization and Referral Representative - USFHP

Providence; Renton (WA); On-site; USD 45,000 - 65,000; Full time

Job summary

Providence Health Plan in Renton, WA seeks a Senior Patient Authorization and Referral Representative to guide members through critical care journeys. You will coordinate insurance verifications, secure fast referral authorizations, and ensure every member feels supported and heard.

Working with our operations team, you’ll influence a five-star healthcare experience from day one. The role emphasizes accuracy, empathy, and timely communication in a dynamic, not-for-profit health plan environment.

Qualifications

• 3 years of Health care or insurance experience.
• 1 year of Prior experience in liaison role for providers and staff.
• 1 year of patient third party eligibility verification experience on an automated patient accounts system.
• 1 year of experience with coding: ICD-10, CPT, HCPCS.

Responsibilities

• Guide members through care journeys by coordinating authorizations and referrals.
• Perform insurance verifications to ensure timely access to care.
• Secure referral authorizations quickly to minimize gaps in treatment.
• Provide compassionate, clear support to members and families throughout the process.

Skills

Healthcare/insurance experience

Liaison with providers/staff

Patient eligibility verification

Tools

ICD-10 coding

CPT coding

HCPCS coding

Job description

Be the healthcare hero our members count on when it matters most. As a Senior Patient Authorization and Referral Representative, you will be the trusted expert guiding members through critical care journeys. You'll champion seamless access to care by navigating insurance verifications, securing fast referral authorizations, and ensuring every member feels supported and heard. Working alongside our dedicated operations team, you'll directly shape a five-star healthcare experience from day one.

US Family Health Plan is a Department of Defense-sponsored health plan for uniformed services members, retirees and their family members. Based in Washington State, PacMed has administered US Family Health Plan for more than 30 years. We have learned best practices that keep people healthy - efficiently and affordably. Due to our not-for-profit status, we can reinvest savings back into operations of the health plan, creating more support and healthier outcomes for beneficiaries.

Required Qualifications:

• 3 years of Health care or insurance experience
• 1 year of Prior experience in liaison role for providers and staff.
• 1 year of patient third party eligibility verification experience on an automated patient accounts system

Preferred Qualifications:

• 1 year of experience with coding: ICD-10, CPT, HCPCS.

Why Join Providence?

Our best-in-class benefitsare uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our missionto advocate, educate and provide extraordinary care.

Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons.