Patient Service Representative

Patient Authorization & Referral Representative

A Division of one of the Top Healthcare Providers in the Pacific Northwest is interested in hiring a Patient Authorization & Referral Representative to their team in the Spokane Valley, Washington area.

Responsibilities :

• Verify insurance benefits and eligibility on all new referrals.
• Perform monthly verification of DSHS coverage for long term Medicaid patients and weekly verification for capitated Hospice 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; work with management and staff to correct omissions, errors, office systems problems, etc.
• Responsible for creating Cost Disclosure / Advance Beneficiary Notices for Medicare patients and tracking for signed form.
• Responsible for generating benefits letter to inform patient / responsible party of financial responsibility and sending to patient.
• 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.
• Obtain PCP referral request and follow-up.
• 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.
• Support and incorporate Sisters of Providence Health System Mission into daily activities.
• Participate in QA / QI.
• Responsible for performing Medicare Part D eligibility and drug formulary checks.
• Prepare hospital charity agreements and send and track patient financial assistance applications.

Skills & Qualifications :

We reserve the right to pay above or below the posted wage based on factors unrelated to sex, race, or any other protected classification. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. This temporary role may be eligible for the following :

Job Type & Location :

This is a Contract to Hire position based out of Spokane Valley, WA. Pay and Benefits : The pay range for this position is $22.00 - $22.00 / hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms.

Workplace Type :

This is a fully onsite position in Spokane Valley, WA.

Application Deadline :

This position is anticipated to close on Nov 20, 2025.