<p>PeaceHealth | PFS Referrals & Eligibility</p> <p>Full-Time (1.0 FTE) | Day Shift | Remote (OR, WA, AK only)</p> <p>Pay Range: $24.32 - $32.84/hr</p> <p>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.</p> <p>Location requirement</p> <p>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.</p> <p>Why this role, why now</p> <p>If you've ever felt like referral work is all volume, constant queues, and little connection to the patient, this role is built differently.</p> <ul> <li>Be the difference-maker behind patient access. Your work directly clears the path for care, getting patients to treatment faster, with fewer barriers. </li><li>Less churn, more ownership. You'll manage referrals end-to-end, not just pass them along. </li><li>Remote work with real connection. Work from home while staying tied to a local PeaceHealth hospital and care teams. </li><li>Join a system investing in access now. We're actively improving how patients move through care, and referrals are central to that change. </li><li>Feel your impact daily. You'll see how your work reduces delays, denials, and patient anxiety. </li></ul> <p>What you'll do (no jargon, just real work)</p> <ul> <li>Review referral and prior authorization requests and make sure nothing is missing. </li><li>Contact insurance providers to secure approvals for procedures, tests, and treatments. </li><li>Follow each case through, not just submitting, but making sure it gets completed. </li><li>Talk with patients when needed so they understand what's happening and what to expect. </li><li>Coordinate with providers, clinics, and specialists to ensure referrals move smoothly. </li><li>Track updates, decisions, and important details clearly in the patient record. </li><li>Stay current on insurance rules and adjust quickly when requirements change. </li><li>Step in to resolve denials or delays so care doesn't stall. </li></ul> <p>Success Matrix: What great looks like here</p> <p>In this role, success isn't about how many referrals you touch, it's about what happens because you did.</p> <ul> <li>Patients get scheduled sooner because approvals are handled right the first time </li><li>Fewer denials due to complete, accurate submissions </li><li>Patients feel informed instead of confused about their care journey </li><li>Providers trust that referrals won't fall through the cracks </li><li>Care moves forward without unnecessary delays </li></ul> <p>What you bring (Qualifications)</p> <ul> <li>3 years of direct experience verifying and submitting referrals and/or prior authorizations </li><li>A clear understanding of the difference between a referral and a prior authorization </li><li>Ability to manage multiple priorities while staying organized and accurate </li><li>Strong organizational skills with the ability to quickly locate and recall information </li><li>Clear, professional communication and comfort receiving ongoing feedback </li><li>Experience working with insurance requirements across procedures, therapies, or diagnostics </li><li>Comfort navigating multiple systems and working independently in a remote environment </li><li>A dedicated workspace with minimal distractions during working hours </li></ul> <p>Nice to have (but not required)</p> <ul> <li>Strong critical thinking skills and the ability to problem-solve through complex cases </li><li>Experience working both independently and collaboratively, with a mindset that values teamwork and shared success </li><li>Patience and adaptability when working with diverse patients, providers, and teammates </li></ul> <p>Our culture at PeaceHealth</p> <p>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.</p> <ul> <li>People-first mindset; for patients and caregivers </li><li>Inclusive environment where different backgrounds and perspectives are respected and welcomed </li><li>Supportive teams that value communication, feedback, and shared accountability </li><li>Mission-driven work rooted in compassionate care for our communities </li></ul> <p>We care about your whole well-being, physical, emotional, financial, and spiritual, and offer a comprehensive benefits package including medical, dental, vision, retirement contributions, paid time off, and mental health support.</p> <p>See how PeaceHealth is committed to Inclusivity, Respect for Diversity and Cultural Humility.</p>