Referral Specialist - Park Ridge GI, IL

Dallas Regional Medical Center; Park Ridge (IL); On-site; USD 10,000 - 60,000; Full time

Job summary

A leading healthcare organization in Park Ridge is seeking a Referral Specialist to ensure effective communication between patients and providers. The role focuses on processing referrals, handling insurance authorizations, and fostering positive patient relationships. Candidates are expected to have experience in a clinical environment and knowledge of medical terminology, with a strong emphasis on customer service and organizational skills.

Benefits

401K plan

Medical, dental, and vision coverage

Paid time off

Tuition reimbursement

Qualifications

• 2 years of experience in a clinical environment preferred.
• Completion of a medical assistant program desired; certification within 6 months of hire.
• Excellent phone and customer service skills.

Responsibilities

• Acts as a liaison between insurance, healthcare providers, and the clinic.
• Reviews clinical data to report medical necessity to insurance companies.
• Handles prior authorizations and fosters relationships with specialists.

Skills

Customer service

Communication

Organization

Detail-oriented

Prior authorizations

Knowledge of medical terminology

Education

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 an all-inclusive list of responsibilities, duties, and skills required. 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. Makes referrals to specialists, handles prior authorizations, and fosters positive relationships between the practice and specialists. Additional 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 knowledge of referral processes, tests, surgeries, and insurance plans. Must have good telephone etiquette and communicate politely and friendly with patients and staff. Should navigate prior authorizations efficiently and support patients using resources like sliding fee scales and payment arrangements. Conveys a positive organizational image and maintains a customer-friendly attitude for both internal and external customers.

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. Upbeat, positive, customer-friendly attitude.

7. Knowledge of prior authorizations and insurance plans.

8. Good organizational skills.

9. Ability to act as a patient liaison and assist in navigating the healthcare system.

10. Self-starter, able to multi-task.

11. Ability to organize and troubleshoot scheduling and referral issues, providing solutions.

12. Detail-oriented.

13. Adaptable to a changing environment.

Prime Healthcare Illinois Medical Group offers competitive compensation and a comprehensive benefits package, including paid time off, a 401K 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 offer based on experience, education, credentials, and other factors.

The company is committed to empowering staff with a comprehensive, customizable benefits package to support individual growth and well-being. Learn more at: https://www.primehealthcare.com/benefitsthatmattermost/

Employment Status: Full Time

Shift: Days