Additional Position Details: FTE: 1.000000 | Full Time | Primarily Monday-Friday/0800-1700
Starting Wage: $20.53-$28.23 per hour, depending on experience
Position Summary
The Referral and Authorization Specialist is responsible for processing all referrals from the assigned area of specialty. This includes securing pre-authorizations when necessary to facilitate timely appointments and support continuity of care within the health system.
As a Referral and Authorization Specialist for Asante, you will have the opportunity to:
- Receive and transcribe all referrals in Asante's referral tracking system, assist with coordinating the scheduling of care based on clinical protocols, and send confirmation for scheduled services to the patient.
- Ensure patient demographic and insurance information accompanying the referral is accurate and complete and follow up with referring clinics and/or patients as needed to fill in missing or incorrect information.
- Obtain pre-authorizations and pre-certifications from third-party payers in accordance with payer requirements and document the authorization number and period of validity in referral.
- Gather additional medical records from other providers as needed to support medical necessity when obtaining a preauthorization and follow up with payers on pre-authorization requests as needed.
- Identify patients who will need to receive Medicare Advance Beneficiary Notices of Noncoverage, along with Waivers for Oregon Health Plan and Commercial insurance patients.
- Accurately enter all referral information into appropriate systems daily in order to schedule the initial evaluation and follow up appointments as needed.
- Ensure Therapists have all clinical information necessary for referral appointments & authorization forms and sending any additional documents upon request.
- Alert the therapist involved in the patient's care when there are issues with referrals or complications with insurance coverage.
- Inform the patient whether the authorization for the referral has been approved or denied, and discusses what other possible form of payment may be applicable.
Qualifications
- Minimum of 2 years of healthcare related insurance, scheduling, front desk, or comparable experience is required
- Associate Degree in business or healthcare-related field- preferred
- CHAA: Certified Healthcare Access Associate- preferred
Total Rewards
We offer a comprehensive Total Rewards package designed to support your well-being and professional growth, including:
- Competitive Pay: Hourly and salaried positions earn market-based compensation.
- Health & Wellness: Medical, dental, and vision coverage for part-time and above employees and their eligible dependents beginning within 30 days of hire.
- Retirement Savings: Employer-sponsored retirement plan with company contribution and match.
- Paid Time Off: Generous ETO for part-time and above employees.
- Professional Development: Continue to enhance your education through our tuition reimbursement and tuition repayment program
- Additional Benefits: Life insurance, disability coverage, and employee assistance programs.
At Asante, we are guided by our values:
Excellence - Respect - Honesty - Service - Teamwork
Asante is proud to be an Equal Opportunity Employer. We are committed to creating a diverse and inclusive workplace and to employing and advancing qualified individuals of all backgrounds, including women, minorities, individuals with disabilities, and protected veterans.