Referral Specialist - Park Ridge GI, IL

Huntington Beach Hospital; Park Ridge (IL); On-site; USD 10,000 - 60,000; Full time

Job summary

A leading hospital in Park Ridge seeks a Referral Specialist to manage patient referrals and insurance communications. This full-time position requires knowledge of medical terminology and excellent customer service skills. Ideal candidates will have experience in a clinical setting and be able to navigate prior authorizations effectively.

Benefits

Paid time off

401K

Medical, dental, vision benefits

Tuition reimbursement

Qualifications

• 2 years of experience in a clinical work environment preferred.
• Certification within 6 months of hire desired.
• Self-starter capable of multitasking.

Responsibilities

• Acts as a liaison for insurance and healthcare providers.
• Responsible for scheduling referrals and managing prior authorizations.
• Maintains a positive, customer-friendly attitude for all interactions.

Skills

Medical terminology

Customer service skills

Organizational skills

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 required referrals are processed correctly for medical specialty visits. The Referral Specialist is responsible for scheduling referrals for patients at the request of providers and/or staff. Direct communication with clinics, referred clinics, and patients is essential. Reviews clinical data to report medical necessity to insurance companies. Performs all work aligned with the mission, vision, and values of the practice. The Referral Specialist makes referrals to specialists for office practices, manages prior authorizations, 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 referral processes, terminology, and tests/surgeries, along with insurance plans. Good telephone etiquette and the ability to communicate politely and professionally with patients and staff are required. The role involves navigating prior authorizations with insurance companies and supporting patients through resources like sliding fee scales and payment arrangements. Conveys a positive organizational image and maintains an upbeat, customer-friendly attitude for internal and external customers.

Qualifications

Education, Experience, Training:

1. 2 years of experience in a clinical work 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, customer-friendly attitude towards internal and external customers.
7. Knowledge of prior authorizations and insurance plans.
8. Good organizational skills.
9. Ability to act as a patient liaison and help navigate the healthcare system.
10. Self-starter capable of multitasking.
11. Ability to organize and troubleshoot scheduling and referral issues with solutions.
12. Detail-oriented.
13. Ability to adapt 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 exact starting salary determined based on experience, education, credentials, and other factors.

The company is dedicated to empowering its staff with a comprehensive, competitive benefits package that allows customization to individual needs. Resources, programs, and voluntary options support personal growth and well-being. Learn more here: https://www.primehealthcare.com/benefitsthatmattermost/

Employment Status: Full Time

Shift: Days