Senior Patient Authorization and Referral Representative - USFHP

Providence Health Plan Group; Renton, Northern (WA, KY); Hybrid; USD 36,000 - 55,000; Full time

Job summary

Providence in Renton, WA seeks a Senior Patient Authorization and Referral Representative to guide members through critical care journeys, verify insurance, and secure timely referrals. You will support our operations team in delivering compassionate, seamless access to care from day one.

Join a mission-driven team and help ensure a five-star experience for every member through accurate eligibility checks and proactive coordination of care pathways.

Qualifications

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

Responsibilities

• Guide members through care journeys and secure referral authorizations
• Navigate insurance verifications to ensure timely access to care
• Support operations and contribute to a five-star healthcare experience from day one

Skills

Health care experience

Liaison experience

Eligibility verification

Tools

ICD-10/CPT/HCPCS coding

Job description

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 benefits are 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 mission to 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.

About Providence

At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.
Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.

About the Team

Providence Clinical Network (PCN) is a service line within Providence serving patients across seven states with quality, compassionate, coordinated care. Collectively, our medical groups and affiliate practices are the third largest group in the country with over 11,000 providers, 900 clinics and 30,000 caregivers.

PCN is comprised of Providence Medical Group in Alaska, Washington, Montana and Oregon; Swedish Medical Group in Washington’s greater Puget Sound area, Pacific Medical Centers in western Washington; Kadlec in southeast Washington; Providence’s St. John’s Medical Foundation in Southern California; Providence Medical Institute in Southern California; Providence Facey Medical Foundation in Southern California; Providence Medical Foundation in Northern and Southern California; and Covenant Medical Group and Covenant Health Partners in west Texas and eastern New Mexico.

Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.

Requsition ID: 459222
Company: Pacific Medical Jobs
Job Category: Patient Access
Job Function: Revenue Cycle
Job Schedule: Full time
Job Shift: Multiple shifts available
Career Track: Admin Support
Department: 3060 WA USFHP
Address: WA Renton 620 Naches Ave SW
Work Location: Blackriver Corporate Park-Renton
Workplace Type: On-site
Pay Range: $25.61 - $39.88
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.