PATIENT ACCESS REFERRAL AND AUTHORIZATION SPECIALIST in Elma, Washington at Summit Pacific Medical Center

Get to know Summit Pacific Medical Center:

Your trusted partner in Health and Wellness, Summit Pacific is a vibrant and expanding public hospital district that operates a Critical Access Hospital with a Level IV trauma designation, three rural healthcare clinics, and a seven-day-a-week urgent care clinic. Our vision is “Through Summit Care, we will build the healthiest community in the Nation.” Our hospital is unique due to its size and accessibility. We pride ourselves on our ability to give patients quick access to a provider.

• Critical Access Hospital
• 24/7 Emergency Department
• Level II Cardiac Center
• Level III Stroke Center
• Level IV Trauma Care

To learn more about Summit Pacific, visit www.summitpacificmedicalcenter.org

Sign on bonus $1,000.00 with a 14-month commitment.

About the team:

The Patient Access Referral Authorization Specialist coordinates and facilitates the process of internal and external referrals and authorizations for the Summit Pacific Medical Center (SPMC). Referral and authorization processes include verifying insurance eligibility and benefits, medical necessity, procedure and diagnosis coding, understanding payer specific network restrictions, contracted providers and facilities. This position is accountable for efficient follow through on all aspects of these processes, including communication with patients, health care providers, insurance providers and other departments inside and outside the SPMC.

Required Education and Experience:

1. High school diploma or equivalent required, Associates degree preferred.
2. Healthcare experience preferred.
3. Knowledge of medical terminology preferred.
4. Knowledge of healthcare revenue cycle preferred.

Required Licenses, Certifications and/or Registration:

1. Basic Life Support (BLS) certification encouraged.

Job Specific Duties:

1. Responsible for the facilitation of referrals and authorizations for new and established SPMC patients, while demonstrating SPMC values by providing excellent, and compassionate customer service.
2. Works closely with specialty service providers, home healthcare agencies, outside vendors, pharmaceutical companies, and other outside facilities and organizations.
3. Communicate with patients and providers regarding referrals for services and provision of care. Responsible for insurance eligibility and benefit verification.
4. Responsible for obtaining prior authorizations for SPMC clinic and hospital services. Works directly with Patient Access Specialists to schedule patients for services after authorizations have been obtained. Works closely with billing and revenue cycle departments to assist with authorization denials and appeals, and with Financial Counselor to assist in customized financial care plans.
5. Accurately process incoming, outgoing, and inter-office mail.
6. Research and analyze alternatives for improving workflows. Assist in the development of “best practice” recommendations by partnering with other team members in examining data and identifying trends.
7. Perform all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards.
8. Performs special projects and other related duties as assigned.

This is a union position with a pay range of $20.17 to $28.15 per hour, depending on experience.

BENEFITS:

Our uniquely designed benefits are here to support you and your family in staying well, growing professionally and achieving financial security!

We take care of you, so you can focus on delivering our mission of caring for everyone, especially the most vulnerable in our communities.

Benefits offered by SPMC:

• Competitive Compensation
• Medical
• Prescription
• Dental (including Orthodontia)
• Vision
• Healthcare FSA and daycare FSA
• Daycare subsidized benefit
• Life Insurance
• Accidental Death and Dismemberment (AD&D)
• Short- and long-term disability
• Generous employer 403b match contributions for retirement
• 457 retirement account for additional funds
• Employee Assistance Program (EAP)
• Tuition reimbursement
• Smoking Cessation Assistance
• Employee Wellness Program
• Employee Committees to participate in such as Spirit Team
• Beautiful on-site gym for employees
• Instructor led fitness classes for employees, including Yoga, Kettlebells and Bootcamps
• Walking trails on site