Referral Specialist - Park Ridge GI, IL

St. Mary's General Hospital; Park Ridge (IL); On-site; USD 10,000 - 60,000; Full time

Job summary

A leading healthcare provider is seeking a Referral Specialist to ensure efficient scheduling of patient referrals and insurance communications. The ideal candidate will have a strong foundation in medical terminology, excellent customer service skills, and the ability to manage multiple tasks in a dynamic environment. Comprehensive benefits include paid time off and health coverage.

Benefits

Paid time off

401K retirement plan

Medical coverage

Dental coverage

Vision coverage

Tuition reimbursement

Qualifications

• 2 years experience in a clinical environment preferred.
• Knowledge of medical terminology desired.
• Ability to work in a changing environment.

Responsibilities

• Acts as a liaison between insurance and the clinic.
• Schedules referrals for patients.
• Communicates directly with clinics and patients.

Skills

Customer service

Organization

Communication

Education

Medical assistant certificate

Tools

Electronic Medical Records systems

Job description

Overview

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

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 clinics, referred clinics, and patients.
• Reviews clinical data to report medical necessity to insurance companies.
• Performs all work in accordance with the mission, vision, and values of the practice.
• The Referral Specialist makes referrals to specialists for the office practices along with prior authorization and fosters positive relationships between office practices and specialists.
• Other duties include filing/scanning patient reports, retrieving patient records for prior authorizations or medical records, and completing insurance prior authorizations.
• The Referral Specialist should demonstrate adequate knowledge of the terminology related to the referral process, tests, surgeries, and 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 navigate prior authorizations with insurance companies and support patients using resources such as sliding fee scales and payment arrangements.
• Conveys a positive image of the organization and maintains an upbeat, customer-friendly attitude for internal and external customers.

Qualifications

• 2 years of experience in a clinical work environment preferred.
• Knowledge of medical terminology preferred.
• Completion of a medical assistant program desired; certification within 6 months of hire.
• Knowledge of Electronic Medical Records systems.
• Excellent phone and customer service skills.
• Upbeat, positive, customer-friendly attitude towards internal and external customers.
• Knowledge of prior authorizations and insurance plans.
• Good organizational skills.
• Ability to act as a patient liaison and help navigate the healthcare system.
• Self-starter capable of multi-tasking.
• Ability to organize and troubleshoot scheduling and referral issues with solutions.
• Detail-oriented.
• Ability to work in a changing environment.

Prime Healthcare Illinois Medical Group offers competitive compensation and a comprehensive benefits package, including paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and voluntary benefits. The estimated total compensation range for this role is $18.15 to $24.42 per hour, with the exact starting salary determined based on experience, education, credentials, and other factors.

Employment Status: Full Time

Shift: Days