Referral Authorization Specialist

Location: Bradford Regional Medical Center, Bradford, PA. Work Type: Full-Time, Shift 1.

About the role

Assures that all referrals are managed effectively and efficiently for ancillary testing. Provides high-level customer service to both referring physicians as well as referred patients. Obtains pre-authorization for all ancillary tests and performs additional administrative support functions. This job requires the application and interpretation of policies and procedures and the use of independent judgment in a medical setting. The individual must possess the ability to maintain a working knowledge of the insurance criteria and regulations as it pertains to ancillary testing of the carrier contracts/changes. This position can be reassigned to any location within OGH/BRMC offices as may be required to meet business needs.

Responsibilities

• Manage referrals for ancillary testing effectively and efficiently.
• Provide high-level customer service to referring physicians and referred patients.
• Obtain pre-authorization for all ancillary tests.
• Perform additional administrative support functions.
• Apply and interpret policies and procedures; use independent judgment in a medical setting.
• Maintain working knowledge of insurance criteria and regulations related to ancillary testing and carrier contracts/changes.
• Be prepared to reassignment to any OGH/BRMC location as business needs require.

Requirements

• High School diploma or equivalent.
• For LPN applicants: completion of an accredited Licensed Practical Nurse program.
• Current and valid driver’s license.
• Current and valid Pennsylvania LPN license (LPN applicants only).
• Two (2) years experience in a medical office setting with billing and insurance experience.
• LPN applicants must have two (2) years experience in a physician office setting with billing and insurance experience.

Skills

• Visual and auditory acuity.
• Manual dexterity.
• Language and interpersonal skills.
• Knowledge of personal computer and word processing (preferred).

Pay

Salary range: $16.00 - $21.66 per hour. Pay frequency: Bi‑weekly. Wage determined based on experience, qualifications, internal equity, and any applicable collective bargaining agreement.

Schedule

• Standard hours: 75.00 bi‑weekly.
• Scheduled work hours: 8 am – 5 pm.
• Weekend/holiday requirement: No.
• On‑call required: No.
• Rotation: No.