Referral Coordinator - General Surgery

PeaceHealth • Vancouver, WA

2d

About The Position

PeaceHealth is hiring a full-time Referral Coordinator for its General Surgery team. The position assures that services approved by private payors have been completed and requests additional visits as patients continue through their episodes of care. The coordinator may also manage referrals, working closely with team members to support appropriate utilization and cost containment, and provides clerical support to staff.

The role oversees referral data entry and form completion, obtains insurance pre-authorizations and reauthorizations, and ensures insurer documentation requirements are met and supporting documents are filed in patient medical records. It manages correspondence with patients, physicians, specialists, and insurance companies; records pertinent referral information; supports adherence to evidence-based standardized guidelines; and coordinates with billing staff and third-party payors to confirm coverage. The role is a day position at 1.00 FTE.

Requirements

• At least 3 years of experience working in insurance in a medical-related field or other related experience.
• Demonstrated experience with insurance requirements for referrals and/or prior authorizations for therapies, surgeries, procedures, diagnostic testing, and infusions, including GYN procedures and testing.
• Proficiency with MS Office applications.
• Proficiency with Horizon Home Care.

Nice To Haves

• Accredited school education in business or two years of college.
• Medical Assistant, Licensed Practical Nurse, or Registered Nurse background.
• National Certified Medical Assistant certification.
• Licensed Practical Nurse license in Oregon, Alaska, or Washington.
• Registered Nurse credential.

Responsibilities

• Oversee data entry and completion of referral forms and notifications.
• Obtain insurance pre-authorization and reauthorization for additional treatment.
• Ensure insurer documentation requirements are met and referral support documentation is filed in the patient’s medical record.
• Manage correspondence with patients, physicians, specialists, and insurance companies.
• Document pertinent information on referral forms and/or in the medical record.
• Ensure practitioners follow standardized guidelines recommended by evidence-based medicine.
• Communicate with billing staff and third-party payors to assure coverage of patient care.
• Provide clerical support and assistance to staff.
• Perform other duties as assigned.

Benefits

• Full medical, dental, and vision coverage.
• 403(b) retirement plan with employer base and matching contributions.
• Paid time off.
• Employer-paid life and disability insurance, with additional buy-up coverage options.
• Tuition and continuing education reimbursement.
• Wellness benefits.
• Expanded EAP and mental health program.

What This Job Offers

• Job Type: Full-time
• Education Level: No Education Listed