Referral Specialist - Park Ridge GI, IL

Ascension Medical Group; Park Ridge (IL); On-site; USD 10,000 - 60,000; Full time

Job summary

Ascension Medical Group is seeking a Referral Specialist who will act as a liaison between insurance and healthcare providers, ensuring smooth referrals for medical visits. The role requires effective communication and organizational skills, with a focus on customer service and detail-oriented tasks in a clinical environment. Full-time position, shifts are during the day.

Benefits

Paid time off

401(k) plan

Medical, dental, and vision coverage

Tuition reimbursement

Voluntary benefits

Qualifications

• 2 years of experience in a clinical environment preferred.
• Certification within 6 months of hire desired.
• Knowledge of prior authorizations and insurance plans.

Responsibilities

• Acts as a liaison between insurance, healthcare providers, and the clinic.
• Responsible for scheduling referrals and processing authorizations.
• Communicates with clinics, referred clinics, and patients.

Skills

Knowledge of medical terminology

Excellent phone skills

Customer service skills

Organizational skills

Attention to detail

Multitasking 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

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. Direct communication with clinics, referred clinics, and patients is essential. Reviews clinical data to report medical necessity to insurance companies. Performs work aligned with the mission, vision, and values of the practice. Makes referrals to specialists, handles prior authorization, and fosters positive relationships between office practices and specialists. Additional duties include filing/scanning reports, retrieving patient records for prior authorizations or medical records, and completing insurance prior authorizations. Demonstrates knowledge of referral processes, tests, surgeries, and insurance plans. Maintains good telephone etiquette and communicates politely and professionally with patients and staff. Navigates prior authorization processes and supports patients through resources such as sliding fee scales and payment arrangements. Conveys a positive image of the organization and maintains a friendly, customer-focused attitude both internally and externally.

Qualifications

EDUCATION, EXPERIENCE, TRAINING

1. 2 years of experience in a clinical environment preferred.
2. Knowledge of medical terminology preferred.
3. Completion of a medical assistant program is desired; certification within 6 months of hire.
4. Knowledge of Electronic Medical Records systems.
5. Excellent phone and customer service skills.
6. Positive, upbeat, and customer-friendly attitude.
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 multitasking abilities.
11. Ability to troubleshoot scheduling and referral issues and provide solutions.
12. Attention to detail.
13. Ability to adapt to a changing environment.

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

Employment Status: Full Time

Shift: Days