Central Oregon Pediatric Associates (COPA) of Bend, Oregon, the largest pediatric practice in the region, is hiring a full time Prior Authorization & Referral Coordinator.

At COPA, the Prior Authorization & Referral Coordinator plays an integral role serving patients at our friendly and welcoming medical clinic for children of all ages. The Prior Authorization & Referral Coordinator primarily supports patients and families with their referral and medical authorization needs as directed by the primary care provider (PCP).

The role of the Prior Authorization & Referral Coordinator will include but is not limited to the following duties:

Maintains an in-depth knowledge of principles, practices, standards, and techniques and demonstrates knowledge in accordance with COPA policies and procedures within pertinent laws and regulations in the following areas:

• As directed by the Primary Care Provider (PCP), supports patients and families with timely referrals to specialists outlined by the patient’s insurance plans and in the scheduling of patients within and outside our facility as appropriate.
• Tracks referrals to consulting specialty providers and community service providers ordered, including referral status and whether consultations results have been communicated to patients, families or caregivers and clinicians.
• Demonstrates active involvement and coordination of care when patients receive care in specialized settings.
• Tracks and communicates the status of referrals as they move through the referral process, ensuring proper follow up documentation and communication when the referral has been completed.
• Documents and details all pertinent referral and authorization information in the patients’ electronic health record.
• Maintains and updates referral and authorization resource lists regarding insurance, referral and pre-authorization guidelines, drug formularies, contracted physicians, etc.
• Assists with medication authorizations between the provider, pharmacy, and patient.
• Meets departments patient-centered performance metrics for timely delivery of services and works with manager to review performance and set goals.
• Support the patient and family with education and follow up regarding the prior authorization and referral processes.
• Follow up with patient regarding status of referrals and or pre-authorizations.

Qualifications
Education and Certification:

• HS Diploma or equivalent of HS Diploma.

Experience:

• Referral and authorization experience preferred.
• Exceptional phone and communication skills. Ability to communicate effectively, both written and orally.
• Excellent customer service skills.
• Knowledge of standard medical terminology.
• Epic EMR experience preferred. Proficient with Microsoft Office Suite.
• Bilingual in Spanish and English a plus.

Physical Requirements:

• Use of clear and audible speaking voice and the ability to hear normal speech level in person, over the telephone or through use of other required technology. Sitting or standing for long periods of time. Frequent repetitive motion includes computer keyboard use, reaching with hands and arms, and walking. Occasional lifting and or moving up to 30 pounds and on rare occasions up to 50 pounds. Specific vision abilities required include viewing computer monitor for long periods of time, close vision, distance vision, color vision, peripheral vision, and depth perception.
• Must be able to wear appropriate personal protective equipment (PPE) as required.

Working Conditions:

• Standard medical office; may be eligible for combination of onsite and home office. Refer to Remote Work Policy for details.
• Work inside in a general medical office setting with ergonomically configured equipment.
• The employee is subject to hazards including a variety of physical conditions such as proximity to mechanical parts and chemicals including odors. The employee has been identified as having the likelihood of occupational exposure to blood and other potentially infectious materials, therefore are included in the OSHA Exposure Control Plan with specification for preventing contact with the above materials.
• Travel between COPA clinics and business office as required.

In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification form upon hire.

COPA is looking for a candidate with a strong work ethic and a passion for the health of each of our patients. The right candidate will thrive in a private practice where they have the opportunity and flexibility to positively impact the life of a child and their family. If this opportunity resonates with you and you can demonstrate a history of high quality, service-oriented performance, we welcome your application! Please submit a cover letter explaining your desire to work in Pediatrics, your current resume and apply online at www.copakids.com.

COPA is a 5-Star Patient-Centered Primary Care Home, the highest designation, and awarded to clinics which integrate advanced, transformative medical processes and proven best practices for positive patient outcomes. We’re proud of our teams which commit to excellence in a supportive work environment where the patients’ needs come first.

COPA expects all team members, from operations to medical departments, to have a deep commitment to the objectives of COPA, support their fellow team members, and provide the best experience for patients. The right candidate has demonstrated a work ethic that exhibits professionalism while exceeding every expectation of service.

COPA employees are a close-knit group that collaborates to ensure all children are well served. We focus on maintaining a culture of high performance in a personable work environment. The right candidate has a history of positive interactions in team environments, and friendly demeanor toward people of all ages and backgrounds. COPA provides a competitive total pay and benefits package.

About COPA - Central Oregon Pediatric Associates (COPA) has provided excellent, comprehensive, and compassionate medical care to children in Central Oregon for over 45 years. Our mission is to provide all children with outstanding medical care and exceed their expectations in a friendly and welcoming environment. COPA is a thriving, independent partnership whose healthcare quality measures exceed all medical care facilities in the region. In addition to pediatric primary care services and procedures, COPA’s Pediatric Center of Excellence also provides behavioral health specialists, lactation services, care coordinators, and newborn patient advocates. We’re committed to serving families where English is not the first language and have interpreters at every location and all shifts. COPA hosts in its clinics over a dozen visiting pediatric specialists from children’s hospitals in Portland, Oregon. COPA has four convenient locations in Bend and Redmond and is open seven days a week with extended hours, and offers 24/7 telephone pediatric nurse advice.

Job Type: Full-time

Benefits:

• 401(k)
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Professional development assistance
• Retirement plan
• Vision insurance

Weekly day range:

• Monday to Friday

Application Question(s):

• This job requires you to live in Central Oregon. Do you reside in the area?

Work Location: Hybrid remote in Bend, OR 97701