Patient Authorization and Referral Representative - Referral Operations

The Patient Authorization and Referral Representative (PARR) is responsible for the implementation of policies and procedures relating to aspects of the Referral Operations department in Providence Medical Group (primary care and specialty clinics) and performs duties supporting the core functional areas of specialist referral processing, diagnostic authorizations, prior authorization, denials/appeals, and training. The work focuses on department support of activities such as production, service level agreements, strategic outcomes, standards and objectives, and performance improvement activities relevant to Referrals Operations. The PARR assures an integrated approach to the program is fulfilled, resulting in timely scheduling of requested services, communication across the continuum of care for requested outpatient services, improvement in the provision of care and services, and improved satisfaction for our patients, providers, staff, and external contacts. The PARR functions in a team environment, providing requested services in a centralized setting on behalf of the medical group clinics.

• H.S. Diploma or GED, or equivalent educ/experience
  • The position requires a minimum of 2 years of experience in a healthcare system. Experience in Professional Billing Revenue Cycle Management is preferred.
• 2 years of experience in Health Care Industry or related field.
  • Physician Office
  • Revenue Cycle
  • Physician or Hospital Billing
  • Health Insurance
  • Outpatient ambulatory
  • Clinical Quality
• 2 years of experience in a referral management functional area such as prior authorization, referrals, appeals, business office or insurance health plans.

• Bachelor's Degree, or equivalent educ/experience
• The position requires a minimum of 2 years of experience in a healthcare system. Experience in Professional Billing Revenue Cycle Management is preferred.
• Epic software experience.
• Experience in database management and spreadsheets.