Providence is calling a Patient Authorization and Referral Representative(1.0 FTE) to Providence Infusion and Pharmacy Services in Spokane Valley, Washington. We are a community of caregivers delivering every day on our Mission to provide compassionate care that is accessible for all - especially those who are poor and vulnerable.
This position is responsible for front-end insurance benefit investigation, obtaining treatment authorizations and providing triage support to referral sources and the clinical team within home infusion. Other responsibilities include entering patient referral data into the database, entering physician information into the database, entering outcomes information into the database, patient notifcation of financial responsibility, and other duties as assigned.
In this position you will:
Verifies insurance benefits and eligibility on all new referrals.
Performs monthly verification of Department of Social and Health Services (DSHS) coverage for long term Medicaid and Managed Medicaid patients.
Assist in evaluation of documentation to determine if patient meets criteria for coverage of therapy.
Gather necessary information to assure accuracy and completeness of forms and reports.
Responsible for creating Cost Disclosure/Advance beneficiary notices for Medicare patients and tracking for signed form.
Document appropriately in patient electronic record regarding payer/billing information.
Obtain initial pre-authorizations as required by insurance plans.
Verification of physician licensure on an ongoing basis.
Responsible for entering new patient and physician date into the software database, including new therapy sessions on existing patients; Enter ICD-9/ICD-10 codes as needed.
Required qualifications for this position include:
- One (1) year experience in medical office setting
Preferred qualifications for this position include:
About the ministry you will serve.
Providence Infusion and Pharmacy Services in Spokane, Washington provides home and ambulatory infusion services to pediatric and adult patients in Washington, Idaho, Montana, and Oregon. Patient quality/safety, satisfaction, and positive clinical outcomes are top priorities. Our services include infusion therapy and enteral/parenteral services to patients in their homes or in our Ambulatory Infusion Suites (AIS), disease management, specialized infusion services, and clinical nurse, pharmacist, and dietitian consulting and support. Spokane is in the heart of the Inland Northwest, offering four seasons of winter snow, cool springs, warm summers, and mild fall temperatures. Outdoor recreational activities are numerous including fishing, hiking, biking, camping, skiing, hunting, golfing, and boating. Spokane is located about 30 miles from Idaho and is within a few hour drive of Seattle, Portland, Missoula, Canada, and the coasts of Washington and Oregon. Spokane is a vibrant community that is easy to navigate with short commute times and offers of a variety of sporting events, concerts, shopping, dining and entertainment experiences.
Our best-in-class benefits are uniquely designed 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.
We offer comprehensive, best-in-class benefits to our caregivers. For more information, visit
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Patient Services
Location: Washington-Spokane Valley
Req ID: 367750