Strategic Referrals & Authorization Specialist

Praxis Health; Bend (OR); On-site; USD 52,000 - 70,000; Full time

Benefits offered by this job

Medical, Dental, Vision with network/专

401(K) with employer match

Paid Time Off

Free in-house lab 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 coverage, submit requests, and track outcomes to ensure timely access to care.

The role requires experience with EHRs, payer portals, and strong attention to detail, organization, and HIPAA compliance within a high‑volume environment.

Qualifications

• High school diploma required; healthcare degree preferred.
• 2+ years in referrals, prior authorizations, medical billing or related roles.
• Knowledge of health insurance plans, payer guidelines, and referral requirements.
• Experience with EHRs, practice management systems, and payer portals.

Responsibilities

• Coordinate referrals and prior authorizations for specialty care, imaging, procedures, and medications.
• Review insurance coverage to determine referral and authorization requirements.
• Submit requests via payer portals, electronic systems, phone, or fax.
• Gather and submit chart notes, diagnostic results, and insurance information.
• Communicate with providers, payers, pharmacies, and facilities to resolve issues.
• Track pending referrals and authorizations and follow up as needed.
• Document approvals, denials, and requests for additional information.
• Maintain accurate EHR documentation of activities.

Skills

Referral processing

Prior authorizations

Insurance verification

EHR proficiency

Documentation accuracy

Time management

Communication

HIPAA compliance

Medical terminology

Team collaboration

Education

Associate/Bachelor in healthcare field

Tools

EHR systems

Practice management

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 coverage, submit requests, and track outcomes to ensure timely access to care.

The role requires experience with EHRs, payer portals, and strong attention to detail, organization, and HIPAA compliance within a high‑volume environment.