*Referral Specialist

Prime Healthcare Illinois Medical Group; Joliet (IL); On-site; USD 24,000 - 34,000; Full time

Benefits offered by this job

Paid time off

401K retirement plan

Medical coverage

Dental coverage

Vision coverage

Tuition reimbursement

Job summary

Prime Healthcare Illinois Medical Group is seeking a referral specialist to coordinate referrals and prior authorizations for patients in our Joliet clinic. You will act as a liaison among doctors, specialists, insurers, and patients, ensuring smooth routing of referrals and timely access to care.

The role requires clinic-based experience, strong phone and customer service skills, and the ability to multi-task in a fast-paced environment.

Qualifications

• 2 year experience in a clinic work environment preferred.
• Knowledge of medical terminology preferred.
• Completion of medical assistant program desired; Certified within 6 months of hire.
• Knowledge of Electronic Medical Systems.
• Excellent phone skills and customer service skills.
• Upbeat, positive, customer friendly attitude towards internal and external customers.
• Knowledge of prior authorizations and insurance plans.
• Good organization skills.
• Be able to act as a patient liaison to help navigate the healthcare system.
• Be a self-starter and able to multi-task.
• Able to organize and troubleshoot scheduling and/or referral issues and have solutions.
• Detailed oriented.
• Be able to work in a changing environment.

Responsibilities

• Acts as a liaison between insurance, healthcare providers, and the clinic to ensure required referrals have been processed correctly for medical specialty visits.
• Schedules referrals for patients at the request of providers and/or staff.
• Directly communicates with the clinics, referred to clinics, and patients.
• Reviews clinical data to report medical necessity to insurance companies.
• Conveys a positive image of the organization and maintains a friendly attitude for internal and external customers.
• Be involved in prior authorizations and patient support using resources such as sliding fee scale and payment arrangements.

Skills

Phone skills

Customer service

Multitasking

Patient liaison

Detail oriented

Education

Medical assistant program

Certification within 6 months

Tools

EMR systems

Job description

Overview

• Department: Primary Care
• Schedule: Monday-Friday
• Facility: Prime Healthcare Medical Group
• Location: 301 N Madison St, Joliet IL

Responsibilities

The following statements are intended to describe the major elements and requirements of the position and should not be taken as an all-inclusive list of responsibilities, duties and skills required of an individual assigned to this job. Acts as a liaison between insurance, healthcare providers, and the clinic to ensure required referrals have been processed correctly for medical specialty visits. The Referral specialist is responsible for scheduling referrals for patients at the request of providers and/or staff. Directly communicates with the clinics, referred to clinics, and patients. Reviews clinical data to report medical necessity to insurance companies. Performs all work with accord to the mission, vision, and values of the practice. The referral specialist makes referrals to specialist for the office practices along with prior auth and creates positive relationships between the office practices and specialists. Other duties include, but are not limited to, filing/scanning patient reports, retrieving patient records for prior authorizations or medical records and completes insurance prior authorization. The Referral specialist should demonstrate adequate knowledge of the usual terminology of Referral process and tests/surgeries along with insurance plans. This person should demonstrate good telephone etiquette and be able to speak to patients and others in a polite and friendly manner. Be able to maneuvers through prior authorization with insurance companies and provide patient support by utilizing resources such as sliding fee scale, payment arrangements etc. Conveys a positive image of the organization and maintains a upbeat customer friendly attitude for internal and external Customers.

Qualifications

EDUCATION, EXPERIENCE, TRAINING

1. 2 year experience in a clinic work environment preferred.

2. Knowledge of medical terminology preferred.

3. Completion of medical assistant program desired Certified within 6 months of hire.

4. Knowledge of Electronic Medical Systems.

5. Excellent phone skills and customer service skills.

6. Upbeat, positive, customer friendly attitude towards internal and external customers.

7. Knowledge of prior authorizations and insurance plans.

8. Good organization skills.

9. Be able to act as a patient liaison to help them through navigate the healthcare system.

10. Be a self-starter and able to multi-task.

11. Able to organize and trouble shoot scheduling and or referral issues and have solutions.

12. Detailed orientated.

13. Be able to work in a changing environment.

Pay Transparency

Prime Healthcare Illinois Medical Group offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $17.40 to $24.42. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

The company is dedicated to empowering its staff with a comprehensive, competitive benefits package, allowing them the freedom to customize their benefits to fit their unique needs. Our abundant resources, programs, and voluntary options serve as a foundation for individual growth and well-being. Learn more here: https://www.primehealthcare.com/benefitsthatmattermost/

Employment Status

Full Time

Shift

Days

Equal Employment Opportunity

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf