{"schemaVersion":"jobsearcher.job.v1","id":"545d0ddd00f1eddd1b310721","url":"https://jobsearcher.com/jobs/545d0ddd00f1eddd1b310721","canonicalUrl":"https://jobsearcher.com/jobs/545d0ddd00f1eddd1b310721","title":"Prior Authorizations & Referrals Coordinator, Bend OR","description":"High Lakes Health Care, part of Praxis Health, is seeking a detail-oriented and organized Referral & Authorization Specialist to support our healthcare team by coordinating patient referrals and managing prior authorization requirements for medications, imaging, procedures, and specialty services.\n\nThis role helps ensure patients receive timely access to appropriate care by working closely with healthcare providers, clinical staff, insurance companies, pharmacies, and outside facilities. The Referral & Authorization Specialist is responsible for reviewing orders and documentation, verifying insurance requirements, submitting authorization requests and referrals, tracking their progress, and maintaining accurate documentation throughout the process.\n\nThe ideal candidate has healthcare experience, a strong understanding of insurance requirements and referral/authorization workflows, excellent attention to detail, and the ability to effectively manage a high-volume workload.\n\nKey Responsibilities\n\nProcess and coordinate referrals and prior authorizations for specialty care, diagnostic imaging, procedures, medications, and other ordered healthcare services.\n\nReview patient insurance coverage to determine referral requirements, prior authorization requirements, network restrictions, and other payer-specific guidelines.\n\nSubmit referrals and prior authorization requests through payer portals, electronic systems, phone, or fax as required.\n\nReview orders and supporting clinical documentation for completeness and obtain additional information from clinical staff when necessary.\n\nGather and submit required documentation, including chart notes, diagnostic results, insurance information, and other supporting clinical records.\n\nCommunicate with providers, clinical staff, insurance representatives, pharmacies, and outside facilities to resolve referral or authorization issues.\n\nTrack pending referrals and authorizations and follow up with payers or receiving facilities as needed to support timely processing.\n\nReview and document authorization approvals, denials, requests for additional information, and other payer determinations.\n\nAssist with redirecting referrals or services when required due to insurance network restrictions, patient preference, or facility availability.\n\nMaintain accurate and timely documentation of referral and authorization activities within the electronic health record (EHR) and/or practice management system.\n\nCommunicate authorization or referral status and requirements to appropriate clinical teams and staff.\n\nMaintain knowledge of payer policies, referral requirements, authorization guidelines, and workflow changes.\n\nPrioritize workload based on urgency, patient needs, payer requirements, and established departmental procedures.\n\nFollow established department policies, procedures, and workflows to support consistent and efficient processing.\n\nQualifications\n\nHigh school diploma or equivalent required; Associate’s or Bachelor’s degree in healthcare administration, health information management, medical assisting, or a related field preferred.\n\n2+ years of healthcare experience preferred , particularly in referrals, prior authorizations, medical billing, insurance verification, patient access, or a related healthcare setting.\n\nKnowledge of health insurance plans, referral requirements, prior authorization processes, and payer guidelines preferred.\n\nExperience working with electronic health record (EHR) systems, practice management systems, and insurance/payer portals .\n\nFamiliarity with medical terminology, diagnosis and procedure codes, clinical documentation, and healthcare workflows.\n\nExperience communicating with insurance companies, healthcare providers, clinical teams, and outside medical facilities preferred.\n\nKey Skills\n\nReferral and prior authorization processing\n\nInsurance verification and payer requirement interpretation\n\nUnderstanding of healthcare documentation and medical terminology\n\nStrong attention to detail and documentation accuracy\n\nExcellent organizational and time-management skills\n\nStrong written and verbal communication\n\nProblem-solving and critical-thinking skills\n\nAbility to prioritize and manage a high-volume workload\n\nAbility to work independently while collaborating effectively with clinical and administrative teams\n\nAbility to adapt to changing payer requirements, workflows, and departmental priorities\n\nCommitment to patient confidentiality and HIPAA compliance\n\nBenefit Highlight\n\nMedical, Dental, Vision with In-Network & Custom Network discounts\n\n401(K) with discretionary employer match\n\nPaid Time Off\n\nFree clinical diagnostic laboratory testing performed in-house\n\nAbout Our Company\nPraxis Health is a family of medical groups providing high-quality healthcare throughout the state of Oregon. Our community-based clinics are the DNA of our business, providing better medicine, advocacy for our patients, and a satisfying and collaborative culture for our providers and staff. The Praxis family approach is dynamically different from other healthcare companies in Oregon. We are not \"big box\" health care, but rather a company of small groups and clinics, of nimble micro-cultures that can quickly adapt to industry changes, as well as patient needs. We have been serving communities across the beautiful and adventurous state of Oregon for over 50 years! And we are pioneers and thought leaders in the industry. Our commitment to innovative and operational excellence has allowed us to create healthcare solutions that are both cost-efficient and cutting edge. Come see how healthcare is done right!\n\nGeneral Physical Requirements\nManual dexterity for office machine operation including computer and calculator; stooping, bending to handle files and supplies, mobility to complete errands for deliveries, or sitting for extended periods of time.\n\nThe employee must regularly lift and/or move up to 10 pounds, frequently lift and/or move up to 25 pounds and occasionally lift and/or move up to 50 pounds.\n\nStress can be triggered by multiple staff demands and deadlines.\n\nWork is performed in an office environment. Involves frequent contact with staff and patients.\n\n#J-18808-Ljbffr","company":"Socket","rawCompany":"socket","city":"Sunriver","state":"OR","isRemote":false,"isActive":true,"createdAt":"2026-09-19T03:33:35.651Z","occupations":[{"code":"43-6013.00","title":"Medical Secretaries and Administrative Assistants","slug":"medical-secretaries-and-administrative-assistants"},{"code":"29-2072.00","title":"Medical Records Specialists","slug":"medical-records-specialists"},{"code":"29-9021.00","title":"Health Information Technologists and Medical Registrars","slug":"health-information-technologists-and-medical-registrars"}],"industries":[{"code":"621111","title":"Offices of Physicians (except Mental Health Specialists)","slug":"offices-of-physicians-except-mental-health-specialists"},{"code":"621498","title":"All Other Outpatient Care Centers","slug":"all-other-outpatient-care-centers"},{"code":"621999","title":"All Other Miscellaneous Ambulatory Health Care Services","slug":"all-other-miscellaneous-ambulatory-health-care-services"}],"jobPosting":{"@context":"https://schema.org","@type":"JobPosting","title":"Prior Authorizations & Referrals Coordinator, Bend OR","description":"High Lakes Health Care, part of Praxis Health, is seeking a detail-oriented and organized Referral & Authorization Specialist to support our healthcare team by coordinating patient referrals and managing prior authorization requirements for medications, imaging, procedures, and specialty services.\n\nThis role helps ensure patients receive timely access to appropriate care by working closely with healthcare providers, clinical staff, insurance companies, pharmacies, and outside facilities. The Referral & Authorization Specialist is responsible for reviewing orders and documentation, verifying insurance requirements, submitting authorization requests and referrals, tracking their progress, and maintaining accurate documentation throughout the process.\n\nThe ideal candidate has healthcare experience, a strong understanding of insurance requirements and referral/authorization workflows, excellent attention to detail, and the ability to effectively manage a high-volume workload.\n\nKey Responsibilities\n\nProcess and coordinate referrals and prior authorizations for specialty care, diagnostic imaging, procedures, medications, and other ordered healthcare services.\n\nReview patient insurance coverage to determine referral requirements, prior authorization requirements, network restrictions, and other payer-specific guidelines.\n\nSubmit referrals and prior authorization requests through payer portals, electronic systems, phone, or fax as required.\n\nReview orders and supporting clinical documentation for completeness and obtain additional information from clinical staff when necessary.\n\nGather and submit required documentation, including chart notes, diagnostic results, insurance information, and other supporting clinical records.\n\nCommunicate with providers, clinical staff, insurance representatives, pharmacies, and outside facilities to resolve referral or authorization issues.\n\nTrack pending referrals and authorizations and follow up with payers or receiving facilities as needed to support timely processing.\n\nReview and document authorization approvals, denials, requests for additional information, and other payer determinations.\n\nAssist with redirecting referrals or services when required due to insurance network restrictions, patient preference, or facility availability.\n\nMaintain accurate and timely documentation of referral and authorization activities within the electronic health record (EHR) and/or practice management system.\n\nCommunicate authorization or referral status and requirements to appropriate clinical teams and staff.\n\nMaintain knowledge of payer policies, referral requirements, authorization guidelines, and workflow changes.\n\nPrioritize workload based on urgency, patient needs, payer requirements, and established departmental procedures.\n\nFollow established department policies, procedures, and workflows to support consistent and efficient processing.\n\nQualifications\n\nHigh school diploma or equivalent required; Associate’s or Bachelor’s degree in healthcare administration, health information management, medical assisting, or a related field preferred.\n\n2+ years of healthcare experience preferred , particularly in referrals, prior authorizations, medical billing, insurance verification, patient access, or a related healthcare setting.\n\nKnowledge of health insurance plans, referral requirements, prior authorization processes, and payer guidelines preferred.\n\nExperience working with electronic health record (EHR) systems, practice management systems, and insurance/payer portals .\n\nFamiliarity with medical terminology, diagnosis and procedure codes, clinical documentation, and healthcare workflows.\n\nExperience communicating with insurance companies, healthcare providers, clinical teams, and outside medical facilities preferred.\n\nKey Skills\n\nReferral and prior authorization processing\n\nInsurance verification and payer requirement interpretation\n\nUnderstanding of healthcare documentation and medical terminology\n\nStrong attention to detail and documentation accuracy\n\nExcellent organizational and time-management skills\n\nStrong written and verbal communication\n\nProblem-solving and critical-thinking skills\n\nAbility to prioritize and manage a high-volume workload\n\nAbility to work independently while collaborating effectively with clinical and administrative teams\n\nAbility to adapt to changing payer requirements, workflows, and departmental priorities\n\nCommitment to patient confidentiality and HIPAA compliance\n\nBenefit Highlight\n\nMedical, Dental, Vision with In-Network & Custom Network discounts\n\n401(K) with discretionary employer match\n\nPaid Time Off\n\nFree clinical diagnostic laboratory testing performed in-house\n\nAbout Our Company\nPraxis Health is a family of medical groups providing high-quality healthcare throughout the state of Oregon. Our community-based clinics are the DNA of our business, providing better medicine, advocacy for our patients, and a satisfying and collaborative culture for our providers and staff. The Praxis family approach is dynamically different from other healthcare companies in Oregon. We are not \"big box\" health care, but rather a company of small groups and clinics, of nimble micro-cultures that can quickly adapt to industry changes, as well as patient needs. We have been serving communities across the beautiful and adventurous state of Oregon for over 50 years! And we are pioneers and thought leaders in the industry. Our commitment to innovative and operational excellence has allowed us to create healthcare solutions that are both cost-efficient and cutting edge. Come see how healthcare is done right!\n\nGeneral Physical Requirements\nManual dexterity for office machine operation including computer and calculator; stooping, bending to handle files and supplies, mobility to complete errands for deliveries, or sitting for extended periods of time.\n\nThe employee must regularly lift and/or move up to 10 pounds, frequently lift and/or move up to 25 pounds and occasionally lift and/or move up to 50 pounds.\n\nStress can be triggered by multiple staff demands and deadlines.\n\nWork is performed in an office environment. Involves frequent contact with staff and patients.\n\n#J-18808-Ljbffr","datePosted":"2026-09-19T03:33:35.651Z","dateModified":"2026-09-19T03:33:35.651Z","hiringOrganization":{"@type":"Organization","name":"Socket","sameAs":"https://jobsearcher.com"},"jobLocation":{"@type":"Place","address":{"@type":"PostalAddress","addressLocality":"Sunriver","addressRegion":"OR","addressCountry":"US"}},"identifier":{"@type":"PropertyValue","name":"JobSearcher","value":"545d0ddd00f1eddd1b310721"},"url":"https://jobsearcher.com/jobs/545d0ddd00f1eddd1b310721"}}