Referral Processing Specialist

aah; Town of Aurora (WI); On-site; USD 29,000 - 43,000; Part time

Benefits offered by this job

Health benefits

Paid time off

Educational assistance

Retirement plan

Job summary

Advocate Health is seeking a Part-time Patient Access Specialist on-site at Aurora Bay Care Hospital in Wisconsin. You will collect and record patient data to initiate home care, palliative, and hospice services, handle intake forms and referrals, and coordinate with the nursing team to ensure the plan of care adheres to scope and safety.

The role requires strong communication, data entry competency, and knowledge of CMS/payer guidelines.

Qualifications

• Strong verbal and written communication skills.
• Experience in clinical or healthcare data entry and customer service.
• Familiarity with EPIC or similar patient management systems.

Responsibilities

• Collect and record medical, social, and reimbursement data for admission to home health, palliative care, and hospice.
• Process intake forms and referrals within EPIC or by fax.
• Coordinate with nursing and care teams to ensure plan of care compliance.
• Explain programs and CMS criteria for admission and refer to appropriate services.
• Maintain knowledge of CMS, Medicaid, and payer guidelines.

Skills

Verbal and written communication

Data entry

Multi-line phone system

Customer service

Detail-oriented

Organizational skills

Education

High School Diploma

Tools

EPIC

Job description

Department:

10422 Home Office WI - Patient Access

Status:

Part time

Benefits Eligible:

No

Hou rs Per Week:

0

Schedule Details/Additional Information:

Per Diem Position On-Site, Monday- Friday at Aurora Bay Care Hospital. Potential hours 830-5p. Weekend and Holiday Rotation requirements may apply. Available for close to full-time orientation.

Pay Range:

$20.80 - $31.20

Major Responsibilities:

Collects and records medical, social and reimbursement data pertinent to patient admission to initiate home care, palliative care and hospice. Screens, documents and processes requests for home health, palliative and hospice services. This includes taking incoming calls, answering customer questions, completing intake forms, processing referral orders within EPIC or faxed referrals and documenting service requests for coordination of care; including promoting company products and service. Collaborates with the nursing team when reviewing and processing physician orders for instructions on patient's plan of care and prior to sending patients to the appropriate patient service department to ensure activities are performed within the scope of practice. Communicates and documents any new, changed, updated information, orders or referrals received within intake to the appropriate persons and/or departments as needed to not compromise the quality of care and safety of patient(s). Responds to inquiries regarding Aurora at Home services and programs. Explains programs and services, in addition to determining if patients meet criteria for Centers for Medicare & Medicaid Services (CMS) certified agency, admission policies and/or referring requests to other community agencies when appropriate. Maintains knowledge of and reference materials of Medicare, Medicaid and third-party payer requirements, payer coverage, guidelines, documentation requirements and insurance related changes or trends.

Licensure, Registration, and/or Certification Required:

None Required.

Education Required:

High School Graduate.

Experience Required:

Typically requires 1 year of experience in a clinical environment.

Knowledge, Skills & Abilities Required:

Basic medical knowledge. Strong verbal and written communication skills a must including experience in data entry, multi-line phone system, and customer service experience. Excellent interpersonal skills necessary to interact with internal and external customers. Demonstrated ability to work well with physicians and other professionals. Proficient computer skills including word processing and electronic mail. Must be detail-oriented and have excellent organizational skills.

Physical Requirements and Working Conditions:

Generally exposed to a normal office environment. Must be able to sit for extended periods and may be required to stand, bend, twist, kneel, squat and reach above the shoulders throughout the workday. May be exposed to hazardous chemicals, loud noises or hazardous equipment when patient care is involved. Position requires travel for education and periodic off site meetings. May be exposed to road and weather hazards.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

Our Commitment to You:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more - so you can live fully at and away from work, including:

• Compensation
  Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
• Premium pay such as shift, on call, and more based on a teammate's job
• Incentive pay for select positions
• Opportunity for annual increases based on performance
• Benefits and more
• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program

Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview.

About Advocate Health

Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is