Referral Coordinator-ACCESS Northwest

Colonial Group; Arlington Heights (IL); On-site; USD 42,000 - 56,000; Full time

Benefits offered by this job

Tuition reimbursement and student loan

Comprehensive healthcare coverage

Generous PTO

403(B) retirement plan

Life Insurance

Cross-departmental committees

Job summary

Access Community Health Network (ACCESS) in Arlington Heights, IL is seeking a referrals specialist to support payors, clinics, and patients in processing referrals and authorizations. You will coordinate with providers and staff to ensure timely scheduling and clear communication.

This role requires a high school diploma, 1 year of health-care office experience, EHR familiarity (EPIC preferred), and strong Microsoft Office skills. Bilingual English/Spanish is a plus.

Qualifications

• High school diploma or GED required.
• Minimum 1-year experience in a clinical office or health care environment in patient registration, referrals, medical assisting or customer service required.
• 1-year EHR Systems experience, preferred, EPIC a plus
• Beginning proficiency Microsoft Office Suite (Word, Excel, Outlook)
• Bilingual English/Spanish a plus

Responsibilities

• Process referrals/authorizations to completion according to policy and procedure.
• Assist providers/staff in identifying appropriate in-network providers for referred services.
• Assist patients with questions regarding referrals.
• Coordinate with other departments and facilities to ensure appointments are scheduled and patients have received necessary information for their appointment(s).
• Work/address the referrals that remain open to determine if patient received the referred services; contact provider to obtain consultation notes; contact patients to ensure they receive referred services.
• Build and maintain relationships with Payor/Plan representatives and ACCESS clinic providers and staff; act as a resource to answer questions and solve problems.
• Maintain accurate information regarding external providers contracted with each Payor/Plan.
• Monitor delays in prior authorization process and work with Prior Authorization Department to ensure timely scheduling.
• Monitor referral phases to maintain compliance
• Monitor referral dashboards and work queues daily

Job description

Who We Are

If you want to work for a mission-driven organization that’s impacting community health care both on a local and national level, then Access Community Health Network (ACCESS) may be the perfect place for you. As a nationally recognized leader in community health, we continue to innovate and improve our integrated care model to address the total health and wellness of our patients. Our dedicated staff are committed to advancing health equity and making a long-term impact on the health outcomes of the more than 150,000 patients that count on ACCESS as their medical home each year.

Position Summary

• Work with Payors/Plans to process referrals/authorizations to completion according to policy and procedure.
• Assist Access Clinic providers/staff in identifying appropriate in-network providers for referred services.
• Assist patients with questions regarding referrals.
• Coordinate with other departments and facilities to ensure appointments are scheduled and patients have received the necessary information for their appointment(s).
• Work/address the referrals that remain open to determine if patient received the referred services. Contact Referred to provider to obtain consultation notes. Contact patients per established policy and procedure to ensure they receive referred services. Close referrals per established policy and procedure.
• Build and maintain relationships with Payor/Plan representatives and ACCESS clinic providers and staff; act as a resource to answer questions and solve problems
• Maintain accurate information regarding which external providers are contracted with each Payor/Plan.
• Monitor for delays in the prior authorization process and works with the Prior Authorization Department to ensure timely scheduling.
• Monitor referral phases to maintain compliance
• Monitor referral dashboards and work queues daily

Requirements

• High school diploma or GED required
• Minimum 1-year experience in a clinical office or health care environment in patient registration, referrals, medical assisting or customer service required.
• 1-year EHR Systems experience, preferred, EPIC a plus
• Bilingual English/Spanish a plus
• Beginning proficiency Microsoft Office Suite (Word, Excel, Outlook)

Benefits

• Tuition reimbursement and student loan forgiveness programs for qualifying individuals
• Comprehensive healthcare coverage including Medical, Dental, and Vision
• Generous PTO
• 403(B) retirement plan and financial resources to help you save and plan for your retirement
• Life Insurance
• Opportunity to participate in cross-departmental committees to innovate and transform our care delivery model and our workplace