Referral Coordinator - Clinic

Advocate Health Care; Chicago (IL); Presencial; USD 42.000 - 65.000; Jornada completa

Descripción de la vacante

Advocate Health Care’s Advocate Medical Group in Chicago is seeking a Referral Coordinator to manage referral requests, secure necessary authorizations, and handle related documentation using the automated managed care system.

The role requires a high school diploma or GED, 3–4 years in a managed care setting with at least one year of referral experience, strong medical terminology comprehension, and the ability to coordinate with physicians, staff, and payers to keep referrals moving.

Formación

• H.S. diploma or GED required.
• 3-4 years in a managed care org, hospital or physician’s office with 1 year referral experience.
• Strong medical terminology comprehension.
• Completion of 1 Medical Terminology class with certificate.

Responsabilidades

• Collect referrals from medical staff daily and obtain approvals from attendings.
• Process referrals for patients based on PCP orders and follow up specialist services.
• Generate correspondence or calls to patients, physicians, staff, managed care orgs or vendors for additional information.
• Prepare correspondence, input referral information in the automated system, and collect supporting documentation.
• Identify problems with payment of charges and coordinate with PHO and managed care specialists.

Conocimientos

Medical terminology

Communication skills

Referral processing

Educación

High school diploma or GED

Medical terminology certificate

Descripción del empleo

Job Description Summary

The Referral Coordinator position is responsible for coordinating all referral requests and following up on all necessary documentation, certification and authorization requirements. A key responsibility is using the automated managed care information system to process referrals.

Where You Will Work

Advocate Medical Group (AMG) is part of Advocate Health, one of the nation’s largest nonprofit health systems. With more than 350 locations across Illinois and Wisconsin, AMG offers a wide range of specialties and services, including primary care, medical and surgical care, pediatrics, women’s health, behavioral health, and more. Our team is dedicated to delivering exceptional care and improving health outcomes in the communities we serve. Joining AMG means being part of a collaborative, patient-focused environment where innovation and quality care thrive.

We’re Looking For

• H.S. diploma or G.E.D.
• 3-4 years experience in a managed care organization, hospital or physician’s office with 1 year referral experience
• Excellent medical terminology comprehension and its effective usage
• Completion of 1 Medical Terminology class with certificate of completion.

What You’ll Do

Monday-Friday 8:30 am-5:00 pm no weekends no holidays

• Collect all referrals from medical staff daily and obtain any necessary approvals from attendings.
• Work in all aspects of the referral process, including processing referrals for patients based on primary care physician orders and follow up specialist services recommended.
• Generates necessary correspondence or calls to patients, physicians and office staff, managed care organizations or vendors requesting additional information and requirements for referral authorization.
• Prepare correspondence, input referral information in the automated system, collects additional medical necessity supporting documentation and provide to appropriate parties for approval.
• Identifies potential problems (i.e., labs, x-rays, procedures, and other physicians) with payment of charges from referral by communication with PHO and other managed care specialists.

About This Location

Chicago, IL - 3134 N Clark St

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Physical Requirements And Working Conditions

• Ability to work independently.
• Ability to handle stress and high workload volumes.
• Ability to communicate denial of services to members and providers.
• If position has direct patient care or direct patient contact the following lifting requirement supersedes any previous lifting requirement effective 06/01/2015. Ability to lift up to 35 pounds without assistance. For patient lifts of over 35 pounds, or when patient is unable to assist with the lift, patient handling equipment is expected to be used, with at least one other associate, when available. Unique patient lifting/movement situations will be assessed on a case-by-case basis.