Prior Authorization and Referral Coordinator - Hybrid

Job Description

Job Description

Description:

Prior Authorization and Referral Coordinator - Hybrid

This position is only available to applicants in Central Oregon

FTE: 1.0

Non-Exempt

Monday - Friday, 8am-5pm

The Opportunity

Help families access the care they need, when they need it most. As the Prior Authorization & Referrals Coordinator, you'll play a vital role in connecting children and families with specialty care, medications, and community resources by coordinating referrals and navigating insurance authorizations. This role is perfect for someone who enjoys solving problems, building relationships, and making complex processes feel seamless for patients. Every day, your work helps remove barriers to care and ensures children receive timely, high-quality healthcare.

The Company

Central Oregon Pediatric Associates (COPA) has been caring for kids and families in Central Oregon for over 50 years, building lifelong relationships and helping children thrive from newborns to teens. Our mission is to provide exceptional, right-fit care for kids at every age and stage, and our vision is to improve the health of all kids in our community. We do this in a welcoming, inclusive environment where collaboration, openness, play and accountability are part of how we care, not just what we do. At COPA, you’ll work alongside people who value kindness, teamwork, and earning families’ trust every single day.

• Coordinate specialty referrals and prior authorizations while keeping patients, families, and providers informed every step of the way.
• Partner with providers, specialists, pharmacies, and insurance companies to ensure timely access to care and medications.
• Track referrals and authorizations from start to finish, maintaining accurate documentation in Epic and following up to ensure completion.
• Educate and support patients and families by answering questions and guiding them through the referral and authorization process.
• Monitor performance metrics, identify opportunities for improvement, and deliver exceptional customer service while maintaining HIPAA compliance.

Benefits

• 401k and Profit sharing

• HSA, HRA and FSA Enrollment

• Medical, Life, Vision and Dental Insurance

• Supplemental insurance Options

• Pediatric Care Benefits

• Employee Assistance Program (EAP)

• Working with Amazing Kids

Education and Certification

• High School diploma or equivalent required

• Recognized certifications include: AHIMA - RHIT, AAPC - CPC

Experience

• Three years of customer service experience required, clerical experience in clinical setting preferred. Intermediate and advanced phone, verbal and computer skills. Ability to work well under pressure with minimal supervision. Flexibility and willingness to handle a variety of tasks

• Ability to handle the changing needs of the department and organization

• Must be flexible and willing to work during the evenings, weekdays and weekends as needed by organization for coverage purposes

• Epic EMR experience preferred. Proficient with Microsoft Office Suite

• Bilingual in Spanish and English a plus

Physical Requirements

• Use of clear and audible speaking voice and the ability to hear normal speech level in person, over the telephone or through use of other required technology. Sitting or standing for long periods of time. Frequent repetitive motion includes computer keyboard use, reaching with hands and arms, and walking. Occasional lifting and or moving up to 30 pounds and on rare occasion up to 50 pounds. Specific vision abilities required include viewing computer monitor for long periods of time, close vision, distance vision, color vision, peripheral vision, and depth perception

• Must be able to wear appropriate personal protective equipment (PPE) as required

Working Conditions

• Work inside in a COPA clinic or personal office (HIPAA Compliant) Setting with ergonomically configured equipment

• Must maintain a consistent and reliable home internet connection that meets the technical requirements necessary to perform the essential functions of this remote role. A minimum internet speed of 100 Mbps download and 10 Mbps upload is required to effectively support COPA systems, secure applications, and video communication

• A professional, confidential, and quiet work environment must be maintained at all times to ensure patient privacy and high-quality service