Washington Referral Authorization Specialist

Job Summary

To support timely patient care and optimal reimbursement, the full-time remote Washington Referral Authorization Specialist will coordinate prior authorizations, manage outgoing referrals, and ensure compliance with payer requirements while working Monday through Friday from 8:00 AM to 4:30 PM PST.

Key responsibilities

• Obtain and manage prior authorizations for various healthcare services, ensuring timely approvals and accurate documentation
• Coordinate outgoing referrals for specialty care and ensure compliance with payer and regulatory requirements
• Review payer policies to minimize denials and collaborate with clinical teams to resolve authorization-related issues

Required qualifications

• High school diploma or equivalent required; Associate degree preferred
• Minimum of two years of experience in healthcare referrals, prior authorizations, or revenue cycle
• Experience with Medicare, Medicaid, and commercial payers
• Strong knowledge of insurance plans and authorization requirements
• Familiarity with EMR systems and payer portals