What are the responsibilities and job description for the Patient Authorization & Referral Representative position at TEKsystems?
*Professional Summary:* The Insurance Verification & Patient Financial Services Specialist plays a vital role in ensuring the accuracy of insurance benefits verification, financial documentation, and regulatory compliance. This position requires attention to detail, strong analytical skills, and the ability to work collaboratively with clinical and administrative teams. The ideal candidate is highly organized, proficient in medical reimbursement processes, and committed to providing exceptional support in patient financial services.
*Key Responsibilities:*
* Verify insurance benefits and eligibility for all new patient referrals to ensure coverage and reimbursement accuracy.
* Perform routine verification of DSHS coverage for long-term Medicaid patients and weekly verification for capitated Hospice patients.
* Assess patient documentation to determine eligibility for therapy coverage under insurance guidelines.
* Gather and review necessary documentation to ensure the accuracy and completeness of patient financial forms and reports.
* Work closely with management and staff to correct documentation errors and address office system challenges.
* Generate and track Cost Disclosure/Advance Beneficiary Notices for Medicare patients to ensure proper financial transparency.
* Prepare and distribute benefit letters informing patients and responsible parties of financial obligations.
* Enter new patient and physician data into the software database, including therapy session updates and ICD-9/ICD-10 coding as required.
* Obtain and follow up on PCP referral requests to facilitate patient care coordination.
* Maintain accurate documentation of payer and billing information in patient electronic health records.
* Obtain initial pre-authorizations as required by insurance plans to support proper medical billing.
* Conduct routine verification of physician licensure to ensure compliance with regulatory requirements.
* Support and uphold the mission of the Sisters of Providence Health System in daily activities.
* Participate in quality assurance and improvement initiatives to enhance operational efficiency.
* Perform Medicare Part D eligibility and drug formulary checks to assist patients with medication coverage.
* Prepare hospital charity agreements and track patient financial assistance applications to promote equitable access to healthcare services.
*Qualifications:*
* Minimum of one year of experience in reimbursement and insurance benefits verification.
* Strong proficiency in medical reimbursement and insurance processes.
* Ability to type efficiently and accurately in a fast-paced environment.
* Effective verbal and written communication skills to support patient interactions and documentation accuracy.
* General computer knowledge, including experience with word processing, spreadsheets, and database software.
* Familiarity with medical terminology and office equipment.
* Strong customer service skills with a focus on patient-centered care.
* Ability to prioritize tasks, manage documentation, and meet strict deadlines.
* High school diploma or GED required.
*Pay and Benefits*
The pay range for this position is $22.00 - $25.00/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. If eligible, the benefits available for this temporary role may include the following:
* Medical, dental & vision
* Critical Illness, Accident, and Hospital
* 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available
* Life Insurance (Voluntary Life & AD&D for the employee and dependents)
* Short and long-term disability
* Health Spending Account (HSA)
* Transportation benefits
* Employee Assistance Program
* Time Off/Leave (PTO, Vacation or Sick Leave)
*Workplace Type*
This is a fully onsite position in Spokane,WA.
*Application Deadline*
This position is anticipated to close on Apr 30, 2025.
About TEKsystems:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
*Key Responsibilities:*
* Verify insurance benefits and eligibility for all new patient referrals to ensure coverage and reimbursement accuracy.
* Perform routine verification of DSHS coverage for long-term Medicaid patients and weekly verification for capitated Hospice patients.
* Assess patient documentation to determine eligibility for therapy coverage under insurance guidelines.
* Gather and review necessary documentation to ensure the accuracy and completeness of patient financial forms and reports.
* Work closely with management and staff to correct documentation errors and address office system challenges.
* Generate and track Cost Disclosure/Advance Beneficiary Notices for Medicare patients to ensure proper financial transparency.
* Prepare and distribute benefit letters informing patients and responsible parties of financial obligations.
* Enter new patient and physician data into the software database, including therapy session updates and ICD-9/ICD-10 coding as required.
* Obtain and follow up on PCP referral requests to facilitate patient care coordination.
* Maintain accurate documentation of payer and billing information in patient electronic health records.
* Obtain initial pre-authorizations as required by insurance plans to support proper medical billing.
* Conduct routine verification of physician licensure to ensure compliance with regulatory requirements.
* Support and uphold the mission of the Sisters of Providence Health System in daily activities.
* Participate in quality assurance and improvement initiatives to enhance operational efficiency.
* Perform Medicare Part D eligibility and drug formulary checks to assist patients with medication coverage.
* Prepare hospital charity agreements and track patient financial assistance applications to promote equitable access to healthcare services.
*Qualifications:*
* Minimum of one year of experience in reimbursement and insurance benefits verification.
* Strong proficiency in medical reimbursement and insurance processes.
* Ability to type efficiently and accurately in a fast-paced environment.
* Effective verbal and written communication skills to support patient interactions and documentation accuracy.
* General computer knowledge, including experience with word processing, spreadsheets, and database software.
* Familiarity with medical terminology and office equipment.
* Strong customer service skills with a focus on patient-centered care.
* Ability to prioritize tasks, manage documentation, and meet strict deadlines.
* High school diploma or GED required.
*Pay and Benefits*
The pay range for this position is $22.00 - $25.00/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. If eligible, the benefits available for this temporary role may include the following:
* Medical, dental & vision
* Critical Illness, Accident, and Hospital
* 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available
* Life Insurance (Voluntary Life & AD&D for the employee and dependents)
* Short and long-term disability
* Health Spending Account (HSA)
* Transportation benefits
* Employee Assistance Program
* Time Off/Leave (PTO, Vacation or Sick Leave)
*Workplace Type*
This is a fully onsite position in Spokane,WA.
*Application Deadline*
This position is anticipated to close on Apr 30, 2025.
About TEKsystems:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
Salary : $22 - $25
