Referral Specialist I

Company: WellSpan Health
Location: York
Posted on: May 28, 2023

Job Description:

Job Description:
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 Essential Accountabilities:

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  Schedules patient appointments with specialty providers including correct processing of necessary referral forms and transfer of patient information.
  
  
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  Ensures patient confidentiality.
  
  
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  Manages the insurance referral process according to policy. Keeps staff current on changes.
  
  
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  Reviews patient insurance to obtain authorizations for diagnostic testing, genetic labs, DME and medications.
  
  
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  Provides insurance company with clinical information necessary to secure authorizations.
  
  
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  Communicates with clinical team when authorization is unable to be obtained.
  
  
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  Maintains referral record in electronic medical record.
  Qualifications
  
  
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  Notes:
  
  
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  Other combinations of formal education, training and experience may be considered.
  
  
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  Minimum Experience:
  
  
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  1 - 2 years of medical insurance experience or experience obtaining authorizations and referrals from insurance companies; medical front office experience preferred
  
  
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  Minimum Education:
  
  
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  High School or G.E.D.
  
  
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  Required Courses:
  
  
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  Medical terminology within 6 months of hire
  
  
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  Physical Demands:
  
  
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  Mostly sedentary work
  
  
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  Occasional prolonged standing/walking
  
  
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  Lifts supplies/equipment
  
  
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  Occasional reaching, stooping, bending, kneeling, crouching
  
  
  Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment.
  WellSpan Health is an Equal Opportunity Employer. It is the policy and intention of the System to maintain consistent and equal treatment toward applicants and employees of all job classifications without regard to age, sex, race, color, religion, sexual orientation, gender identity, transgender status, national origin, ancestry, veteran status, disability, or any other legally protected characteristic.

Keywords: WellSpan Health, Baltimore , Referral Specialist I, Other , York, Maryland