Referral Specialist - Park Ridge GI, IL

Saint Mary's Health Network; Park Ridge (IL); On-site; USD 10,000 - 60,000; Full time

Job summary

A leading healthcare provider is seeking a Referral Specialist to manage patient referrals and prior authorizations while fostering relationships between healthcare providers and patients. This full-time position offers competitive hourly compensation and a comprehensive benefits package including paid time off, medical, dental, and 401K. Candidates should possess customer service skills, organizational abilities, and experience in a clinical environment.

Benefits

Paid time off

401K

Medical, dental, vision

Tuition reimbursement

Voluntary benefits

Qualifications

• 2 years of experience in a clinical environment preferred.
• Knowledge of medical terminology preferred.
• Certification within 6 months of hire required.

Responsibilities

• Acts as a liaison between insurance, healthcare providers, and the clinic.
• Responsible for scheduling referrals at the request of providers.
• Performs work aligned with the practice's mission, vision, and values.

Skills

Excellent phone and customer service skills

Knowledge of prior authorizations and insurance plans

Good organizational skills

Detail-oriented

Self-starter with multi-tasking abilities

Education

Completion of a medical assistant program

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 describe the major elements and requirements of the position and are not all-inclusive. Acts as a liaison between insurance, healthcare providers, and the clinic to ensure referrals are processed correctly for medical specialty visits. The Referral Specialist is responsible for scheduling referrals at the request of providers and/or staff, communicating directly with clinics, patients, and referred providers. Reviews clinical data to report medical necessity to insurance companies. Performs work aligned with the practice's mission, vision, and values. The Referral Specialist makes referrals to specialists, handles prior authorizations, and fosters positive relationships between office practices and specialists. Additional duties include filing/scanning patient reports, retrieving patient records for prior authorizations or medical records, and completing insurance prior authorizations. The individual should demonstrate knowledge of referral processes, tests, surgeries, and insurance plans. Excellent telephone etiquette and polite communication are essential. The role involves navigating prior authorizations, providing patient support through resources like sliding fee scales and payment arrangements, and maintaining a positive, customer-friendly attitude.

Qualifications

1. 2 years of experience in a clinical environment preferred.
2. Knowledge of medical terminology preferred.
3. Completion of a medical assistant program desired; certification within 6 months of hire.
4. Knowledge of Electronic Medical Records systems.
5. Excellent phone and customer service skills.
6. Positive, upbeat attitude towards customers.
7. Knowledge of prior authorizations and insurance plans.
8. Good organizational skills.
9. Ability to act as a patient liaison and navigate the healthcare system.
10. Self-starter with multi-tasking abilities.
11. Ability to troubleshoot scheduling and referral issues with solutions.
12. Detail-oriented.
13. Adaptability to a changing environment.

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

Employment Status: Full Time

Shift: Days