Providence
Patient Authorization and Referral Representative *1.0 Day Shift*
Providence, Beaverton, Oregon, us, 97075
**Description**
**Patient Authorization and Referral Representative**
The primary function of this position involves working with physician offices, inside and outside the Providence organization, in order to facilitate proper handling of exams requiring pre-certifications, referrals or any kind of authorization from an insurance company. This position serves as an expert resource to Diagnostic Imaging staff in regard to the specialist referral/prior authorization requirements for multiple contracted and non-contracted insurance plans, diagnostic imaging protocols that vary between the multiple facilities/sites providing this service, and processes relating to these functions.
Providence caregivers are not simply valued - they're invaluable. Join our team at Providence Portland Medical Center and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.
**Required Qualifications:**
+ 3 years experience in a utilization management functional area such as prior authorization, medical audit, appeals or delegation
+ 2 years Additional years in a business environment doing authorization work, insurance verification, referrals, and/or denials
**Preferred Qualifications:**
+ Bachelor's Degree in Healthcare Administration or work experience in a medical clinic or managed care/health insurance plan (3 years in a related field)
+ CMA or MA with clinical experience working in clinic setting
+ Logician and Pathways® software experience
+ Experience in database management and spreadsheets
**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 of caring for everyone, especially the most vulnerable in our communities.
**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.
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.
Check out our benefits page for more information about our Benefits and Rewards.
**About the Team**
Providence has been serving the Pacific Northwest since 1856 when Mother Joseph of the Sacred Heart and four other Sisters of Providence arrived in Vancouver, Washington Territory. As the largest healthcare system and largest private employer in Oregon, Providence is located in areas ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland.
Our award-winning and comprehensive medical centers are known for outstanding programs in cancer, cardiology, neurosciences, orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit network also provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care.
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:** 304079**Company:** Providence Jobs**Job Category:** Patient Access**Job Function:** Revenue Cycle**Job Schedule:** Full time**Job Shift:** Day**Career Track:** Admin Support**Department:** 5001 PPMC DI ADMIN**Address:** OR Portland 4805 NE Glisan St**Work Location:** Providence Portland Medical Ctr-Portland**Pay Range:** $19.80 - $30.24The 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.Check out our benefits page for more information about our Benefits and Rewards.
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
**Patient Authorization and Referral Representative**
The primary function of this position involves working with physician offices, inside and outside the Providence organization, in order to facilitate proper handling of exams requiring pre-certifications, referrals or any kind of authorization from an insurance company. This position serves as an expert resource to Diagnostic Imaging staff in regard to the specialist referral/prior authorization requirements for multiple contracted and non-contracted insurance plans, diagnostic imaging protocols that vary between the multiple facilities/sites providing this service, and processes relating to these functions.
Providence caregivers are not simply valued - they're invaluable. Join our team at Providence Portland Medical Center and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.
**Required Qualifications:**
+ 3 years experience in a utilization management functional area such as prior authorization, medical audit, appeals or delegation
+ 2 years Additional years in a business environment doing authorization work, insurance verification, referrals, and/or denials
**Preferred Qualifications:**
+ Bachelor's Degree in Healthcare Administration or work experience in a medical clinic or managed care/health insurance plan (3 years in a related field)
+ CMA or MA with clinical experience working in clinic setting
+ Logician and Pathways® software experience
+ Experience in database management and spreadsheets
**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 of caring for everyone, especially the most vulnerable in our communities.
**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.
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.
Check out our benefits page for more information about our Benefits and Rewards.
**About the Team**
Providence has been serving the Pacific Northwest since 1856 when Mother Joseph of the Sacred Heart and four other Sisters of Providence arrived in Vancouver, Washington Territory. As the largest healthcare system and largest private employer in Oregon, Providence is located in areas ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland.
Our award-winning and comprehensive medical centers are known for outstanding programs in cancer, cardiology, neurosciences, orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit network also provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care.
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:** 304079**Company:** Providence Jobs**Job Category:** Patient Access**Job Function:** Revenue Cycle**Job Schedule:** Full time**Job Shift:** Day**Career Track:** Admin Support**Department:** 5001 PPMC DI ADMIN**Address:** OR Portland 4805 NE Glisan St**Work Location:** Providence Portland Medical Ctr-Portland**Pay Range:** $19.80 - $30.24The 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.Check out our benefits page for more information about our Benefits and Rewards.
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