Referral and Authorization Specialist

Description Additional Position Details: FTE: 1.000000 | Full Time | Primarily Mon - Fri / 8AM - 5PM 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 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 Associate Degree in business or healthcare related field, preferred Minimum of 2 years of healthcare-related insurance, scheduling, front desk, or comparable experience is required CHAA: Certified Healthcare Access Associate is 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. Asante