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Referral and Prior Authorization Specialist

November 12, 2025

<span style="-webkit-text-stroke-width:0px;display:inline !important;float:none;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;orphans:2;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;">Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start <strong style="-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:Tahoma, Geneva, sans-serif;font-size:10px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;letter-spacing:normal;orphans:2;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;">Caring. Connecting. Growing together.<span style="-webkit-text-stroke-width:0px;display:inline !important;float:none;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;orphans:2;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;"> The Referral & Prior-Authorization Specialist coordinates and facilitates the process of internal and external referrals and authorizations for patients of The Corvallis Clinic.<o:p></o:p>Schedule: Monday through Friday 8 am to 4:30 pm.PST<o:p></o:p>Location: You’ll enjoy the flexibility to telecommute* from anywhere within a commutable distance to Corvallis, OR . You will work from home when not in training. Training will be held at 3680 NW Samaritan Drive, First Floor, Corvallis, OR 97330.<o:p></o:p>Primary Responsibilities:<ul><li>Will participate and maintain a culture within The Corvallis Clinic that is consistent with the content outlines in the Service and Behavioral Standards Handbook. To this end, employee will be expected to read, have familiarity, and embrace the principles contained within</li><li>Efficiently obtains all authorizations for medical procedures to be performed prior to patients scheduled date of service</li><li>Processes referrals and submit clinical supporting documentation to insurance carriers to expedite prior authorization processes</li><li>Documents all prior authorization information including approval dates, prior authorization number in patient chart</li><li>Reads medical documentation and does medical chart review prior to requesting authorization. Reviews the medical records, diagnosis and laboratory reports. Reviews accuracy and completeness of information requested and ensures that all supporting documents are present</li><li>Notifies scheduling and clinical staff of delays in obtaining these authorizations</li><li>Ensures that insurance carrier documentation requirements are met and authorization/referral documentation is scanned and documented in the patient’s medical record. Reviews order to determine if testing will warrant obtaining an authorization or if the testing is a covered benefit not requiring an authorization through the patient’s insurance coverage. Maintains timely communication with ordering physicians and clinical staff when missing information has not been received</li><li>Completes follow-up as needed with physicians, clinical staff, and insurance companies</li><li>Monitors authorization requests to ensure timely processing and completion</li><li>Communicates approvals and denials to the ordering physician and assists with any denials or issues to resolve</li><li>Reviews denials and submits appeals if requested by physician in an effort to obtain approval by insurance companies</li><li>Researches, corrects, and re-submits rejected and denied claims. Prepares reconsiderations and works with the billing staff if the denial need to go to an appeals level</li><li>Informs supervisor about any changes or patterns when working denials of procedures</li><li>Collaborates with other departments to assist in obtaining pre-authorizations in a cross-functional manner</li><li>Ability to handle high workload volume timely and accurately</li><li>Performs other duties as assigned<o:p></o:p></li></ul><o:p></o:p><o:p></o:p>What are the reasons to consider working for UnitedHealth Group? Put it all together – competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:<ul><li>Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays</li><li>Medical Plan options along with participation in a Health Spending Account or a Health Saving account</li><li>Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage</li><li>401(k) Savings Plan, Employee Stock Purchase Plan</li><li>Education Reimbursement</li><li>Employee Discounts</li><li>Employee Assistance Program</li><li>Employee Referral Bonus Program</li><li>Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)</li><li>More information can be downloaded at: <a target="_blank" rel="noopener noreferrer" href="http://uhg.hr/uhgbenefits">http://uhg.hr/uhgbenefits</a><o:p></o:p></li></ul>You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.<o:p></o:p> Required Qualifications:<o:p></o:p><ul><li>High School Diploma/GED (or higher)<o:p></o:p></li><li>2+ years of experience in a medical office<o:p></o:p></li><li>2+ years of experience interacting with insurance companies</li><li>2+ years of experience in ICD-10 and CPT coding knowledge</li><li>Intermediate level of computer proficiency (including Microsoft Outlook, Teams) and be able to use multiple web applications</li><li>Basic level of computer proficiency including MS Word and Excel<o:p></o:p></li><li>Ability to be on camera during work hours<o:p></o:p></li><li>Reside within a commutable distance to 3680 NW Samaritan Drive, Second Floor, Corvallis, OR 97330. (for training purposes)<o:p></o:p></li><li>Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI)<o:p></o:p></li><li>Live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service<o:p></o:p><o:p></o:p></li></ul>Preferred Qualifications:<ul><li>Knowledge of anatomy and physiology preferred</li><li>Knowledge of medical terminology preferred<o:p></o:p></li></ul>Soft Skills:<o:p></o:p><ul type="disc"><li class="MsoNormal" style="background-color:white;color:black;mso-list:l0 level1 lfo1;mso-margin-bottom-alt:auto;mso-margin-top-alt:auto;mso-pagination:widow-orphan;tab-stops:list .5in;">Strong communication and customer service skills both in person and via phone <o:p></o:p></li><li class="MsoNormal" style="background-color:white;color:black;mso-list:l0 level1 lfo1;mso-margin-bottom-alt:auto;mso-margin-top-alt:auto;mso-pagination:widow-orphan;tab-stops:list .5in;">Ability to work independently and maintain good judgment and accountability <o:p></o:p></li><li class="MsoNormal" style="background-color:white;color:black;mso-list:l0 level1 lfo1;mso-margin-bottom-alt:auto;mso-margin-top-alt:auto;mso-pagination:widow-orphan;tab-stops:list .5in;">Demonstrated ability to work well with others<o:p></o:p></li><li class="MsoNormal" style="background-color:white;color:black;mso-list:l0 level1 lfo1;mso-margin-bottom-alt:auto;mso-margin-top-alt:auto;mso-pagination:widow-orphan;tab-stops:list .5in;">Strong organizational and time management skills <o:p></o:p></li><li class="MsoNormal" style="background-color:white;color:black;mso-list:l0 level1 lfo1;mso-margin-bottom-alt:auto;mso-margin-top-alt:auto;mso-pagination:widow-orphan;tab-stops:list .5in;">Ability to multi-task and prioritize tasks to meet all deadlines <o:p></o:p></li><li class="MsoNormal" style="background-color:white;color:black;mso-list:l0 level1 lfo1;mso-margin-bottom-alt:auto;mso-margin-top-alt:auto;mso-pagination:widow-orphan;tab-stops:list .5in;">Ability to work well under pressure in a fast-paced environment <o:p></o:p></li><li class="MsoNormal" style="background-color:white;color:black;mso-list:l0 level1 lfo1;mso-margin-bottom-alt:auto;mso-margin-top-alt:auto;mso-pagination:widow-orphan;tab-stops:list .5in;">Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying information in a manner that others can understand, as well as ability to understand and interpret information from others <o:p></o:p></li></ul><p style="-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:Tahoma;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;">*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.<o:p></o:p><p style="-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:Tahoma;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;"> <p style="-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:Tahoma;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;"><span class="TextRun SCXO132485085 BCX0 NormalTextRun" style="-webkit-tap-highlight-color:transparent;-webkit-text-stroke-width:0px;-webkit-user-drag:none;font-style:normal;font-variant-caps:normal;font-variant-ligatures:none !important;font-weight:400;letter-spacing:normal;line-height:20.7px;margin:0px;orphans:2;padding:0px;text-align:left;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;user-select:text;white-space:normal;widows:2;word-spacing:0px;" data-contrast="auto" xml:lang="EN-US" lang="EN-US">Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.74 to $31.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable.<span class="EOP SCXO132485085 BCX0" style="-webkit-tap-highlight-color:transparent;-webkit-text-stroke-width:0px;-webkit-user-drag:none;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;line-height:20.7px;margin:0px;orphans:2;padding:0px;text-align:left;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;user-select:text;white-space:normal;widows:2;word-spacing:0px;"> <p style="-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:Tahoma;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;"> <o:p></o:p><p style="-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:Tahoma;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:center;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;">At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.<o:p></o:p><p style="-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:Tahoma;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:center;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;"><o:p></o:p><p style="-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:Tahoma;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:center;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;"> <p style="-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:Tahoma;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:center;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;"> <o:p></o:p><p style="-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:Tahoma;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:center;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;">UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.<p style="-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:Tahoma;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:center;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;"> <o:p></o:p><p style="-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:Tahoma;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:center;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;"><o:p></o:p><p style="-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:Tahoma;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:center;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;">UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.<p style="-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:Tahoma;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:center;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;"> <p style="-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:Tahoma;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:center;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;"> <o:p></o:p><p style="-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:Tahoma;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;"><o:p></o:p><p style="-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:Tahoma;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;"><o:p></o:p><p style="-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:Tahoma;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;">#RPO #GREEN

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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...