Referral Specialist (Referral Center) - York - (full-time) - Days

York, PA | Clerical and Administrative | Tracking Code: 50810

General Summary:

 

 

Under the general supervision of the Supervisor-Contact Center, performs a variety of support functions for each assigned practice including, but not limited to, scheduling, insurance verification, obtaining authorizations and referrals and record management.

 

Duties and Responsibilities:

1 Schedules patient appointments with specialty providers including correct processing of necessary referral forms and transfer of patient information.
2 Ensures patient confidentiality.
3 Manages the insurance referral process according to policy. Keeps staff current on changes.
4 Reviews patient insurance to obtain authorizations for diagnostic testing, genetic labs, DME and medications.
5 Provides insurance company with clinical information necessary to secure authorizations.
6 Communicates with clinical team when authorization is unable to be obtained.
7 Maintains referral record in electronic medical record.

 

Department Description:


The Authorization Center is a centralized WellSpan health department located in a beautifully restored loft building known as the Greenway Tech Building in downtown York.  The personal work spaces are state of the art with ergonomic design, dual 19 inch monitors, natural lighting and task lighting to assist staff with workflow and ensure a comfortable working atmosphere.


 

This department supports an exceptional patient experience by focusing on ensuring that any test, service or procedure that is referred or performed by a WellSpan Provider or Facility has the appropriate authorization and coverage information to ensure adequate reimbursement.


 

 
Required Experience

Minimum Education:

 

High School or G.E.D.

 

 

Minimum Experience:           

 

1 – 2 years of medical insurance experience or experience obtaining authorizations and referrals from insurance companies; medical front office experience preferred

 

 

Required Course(s)/Training:       

 

Medical terminology within 6 months of hire


About WellSpan
Quality of Life

WellSpan Health is an integrated health system that serves the communities of central Pennsylvania and northern Maryland. The organization is comprised of a multispecialty medical group of more than 1,200 physicians and advanced practice clinicians, a regional behavioral health organization, a home care organization, six respected hospitals, more than 15,000 employees, and 140 patient care locations. WellSpan is a charitable, mission-driven organization, committed to exceptional care for all, lifelong wellness and healthy communities. We are committed to transforming the health of the communities we serve and to educating the next generation of clinicians, staff and leaders.

Quality of Life
Quality of Life

Founded in 1741, the city of York is considered by many as the first capital of the United States. The Articles of Confederation were signed by the Second Continental Congress here in 1777. Its beautifully restored historic district is an architectural treasure. While York retains its farming and manufacturing heritage, at its heart York is a thriving cultural community that has attracted creative talent and innovative entrepreneurial investors from across the nation.

Life in York County offers affordable housing, options for higher education, a thriving arts and cultural community, historical attractions, parks and recreational resources, semi-professional baseball team, fine dining and more — within an easy drive of major East Coast cities.

York County residents can find local employment in healthcare, manufacturing, technology, agricultural and service sectors. (Patient population: 445,000)

Equal Opportunity Employment

WellSpan Health is an equal opportunity employer. Employment selection and related decisions are made without regard to sex, race, age, disability, religion, national origin, color or any other protected class. WellSpan Health does, however, have a tobacco-free/nicotine-free hiring policy.

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