Authorizations & Referrals Specialist - Full Time / Days

Job Summary

At Island Health, we're seeking an Authorizations and Referrals Specialist to play a crucial role in supporting the continuity of patient care. This position focuses on coordinating insurance referral and authorization processes, ensuring a clean, safe, and welcoming environment for patients, staff, and visitors.

Location

Anacortes, WA
Onsite
Schedule: Full Time / Days
Salary Range: $20.41 – $30.61 per hour

What You Will Be Doing

• Completes referral and authorization processes with ICD-10 and CPT codes, pertinent documentation, and diagnostic information.
• Verifies active primary insurance coverage in electronic worklists.
• Documents chart notes and confirmation of service in EMR.
• Facilitates routing and release of patient record and other information to Scheduler.
• Discusses and clarifies insurance coverage and problems with referrals with patients.
• Verifies ordered services meet CMS Medical Necessity requirements.
• Sends patients notes of approval/denial of referral or authorization when applicable.
• Works patient electronic worklists daily.
• Works collaboratively with team to assure referrals are processed timely.
• Keeps abreast of new insurance and payer information, contractual updates, or developments as provided.

Requirements

• High School diploma or GED required.
• Additional education or training in ICD-10 Coding encouraged.
• Previous experience working in a Physician Practice or authorizations position strongly preferred.
• The ability to prioritize efficiently, careful attention to detail, problem-solving, and time management skills.
• A working knowledge of claims processing, medical terminology, and CPT & ICD-10 coding.
• Strong computer and time management skills.
• Demonstrated interpersonal, customer service, and organizational skills.
• The ability to effectively multi-task.

Qualifications

• Must have demonstrated ability to interact positively with Administration, Director, Managers, Supervisors, peers, co-workers, subordinates, patients, and visitors.
• Must meet regular attendance standard and must stay at or below average sick leave utilization levels.