What are the responsibilities and job description for the Referral/Pre-Auth Specialist position at PeaceHealth?
Description
Job Description
PeaceHealth | PFS Referrals & Eligibility
Full-Time (1.0 FTE) | Day Shift | Remote (OR, WA, AK only)
Pay Range: $24.32 – $32.84/hr
The hiring rate is dependent upon several factors, including but not limited to education, training, work experience, terms of any applicable collective bargaining agreement, seniority, etc.
Location requirement
This is a remote role. You must live and work in Oregon, Washington, or Alaska and be within a 1-hour drive of a PeaceHealth hospital.
Why this role, why now
If you’ve ever felt like referral work is all volume, constant queues, and little connection to the patient, this role is built differently.
In this role, success isn’t about how many referrals you touch, it’s about what happens because you did.
At PeaceHealth, we believe behind every referral is a real person waiting for care. That perspective shapes how we work, with empathy, collaboration, and respect.
See how PeaceHealth is committed to .
Job Description
PeaceHealth | PFS Referrals & Eligibility
Full-Time (1.0 FTE) | Day Shift | Remote (OR, WA, AK only)
Pay Range: $24.32 – $32.84/hr
The hiring rate is dependent upon several factors, including but not limited to education, training, work experience, terms of any applicable collective bargaining agreement, seniority, etc.
Location requirement
This is a remote role. You must live and work in Oregon, Washington, or Alaska and be within a 1-hour drive of a PeaceHealth hospital.
Why this role, why now
If you’ve ever felt like referral work is all volume, constant queues, and little connection to the patient, this role is built differently.
- Be the difference-maker behind patient access. Your work directly clears the path for care, getting patients to treatment faster, with fewer barriers.
- Less churn, more ownership. You’ll manage referrals end-to-end, not just pass them along.
- Remote work with real connection. Work from home while staying tied to a local PeaceHealth hospital and care teams.
- Join a system investing in access now. We’re actively improving how patients move through care, and referrals are central to that change.
- Feel your impact daily. You’ll see how your work reduces delays, denials, and patient anxiety.
- Review referral and prior authorization requests and make sure nothing is missing.
- Contact insurance providers to secure approvals for procedures, tests, and treatments.
- Follow each case through, not just submitting, but making sure it gets completed.
- Talk with patients when needed so they understand what’s happening and what to expect.
- Coordinate with providers, clinics, and specialists to ensure referrals move smoothly.
- Track updates, decisions, and important details clearly in the patient record.
- Stay current on insurance rules and adjust quickly when requirements change.
- Step in to resolve denials or delays so care doesn’t stall.
In this role, success isn’t about how many referrals you touch, it’s about what happens because you did.
- Patients get scheduled sooner because approvals are handled right the first time
- Fewer denials due to complete, accurate submissions
- Patients feel informed instead of confused about their care journey
- Providers trust that referrals won’t fall through the cracks
- Care moves forward without unnecessary delays
- 3 years of direct experience verifying and submitting referrals and/or prior authorizations
- A clear understanding of the difference between a referral and a prior authorization
- Ability to manage multiple priorities while staying organized and accurate
- Strong organizational skills with the ability to quickly locate and recall information
- Clear, professional communication and comfort receiving ongoing feedback
- Experience working with insurance requirements across procedures, therapies, or diagnostics
- Comfort navigating multiple systems and working independently in a remote environment
- A dedicated workspace with minimal distractions during working hours
- Strong critical thinking skills and the ability to problem-solve through complex cases
- Experience working both independently and collaboratively, with a mindset that values teamwork and shared success
- Patience and adaptability when working with diverse patients, providers, and teammates
At PeaceHealth, we believe behind every referral is a real person waiting for care. That perspective shapes how we work, with empathy, collaboration, and respect.
- People-first mindset; for patients and caregivers
- Inclusive environment where different backgrounds and perspectives are respected and welcomed
- Supportive teams that value communication, feedback, and shared accountability
- Mission-driven work rooted in compassionate care for our communities
See how PeaceHealth is committed to .
Salary : $24 - $33