Referral Specialist – Operations
Advocate Aurora Health
full-time
Posted on:
Location Type: Office
Location: Hazel Crest • Illinois • United States
Visit company websiteExplore more
Salary
💰 $22 - $33 per hour
About the role
- Management and navigation of the centralized referral process.
- Logs member or physician complaints related to ancillary vendors as well as investigates and documents follow-up of complaints.
- Works in all aspects of centralized referral process, including processing referrals to members, physicians and specialists.
- Generates necessary correspondence or calls to members, physicians and office staff, managed care organizations or vendors requesting additional information.
- Communicates with appropriate staff and members regarding follow-up status of referrals.
- Works with UM staff to file, prepare correspondence, data entry, system documentation and other medical management related activities.
- Reconciles and investigates the daily pended claims report to ensure the proper payment of claims in a timely manner.
- Coordinates the initial referral and renewal of home care, DME and disposable supplies under the supervision of RN for the outpatient population.
- Manages cost-effectiveness of DME purchase versus rental.
- Coordinates and monitors discharge planning.
Requirements
- AA Degree or equivalent
- 3-4 years’ experience in a managed care organization, hospital or physician’s office
- Medical record experience preferred and/or medical terminology
- Good verbal and written communications skills.
- Excellent interpersonal communication skills.
- Ability to work as a team member.
- Good computer keyboard proficiency.
- Good organizational skills.
- Ability to handle difficult calls and maintain professional conduct.
- Willingness to be flexible with job responsibilities.
- Certified Medical Assistant preferred.
- MRT preferred.
Benefits
- Paid Time Off programs
- Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
- Flexible Spending Accounts for eligible health care and dependent care expenses
- Family benefits such as adoption assistance and paid parental leave
- Defined contribution retirement plans with employer match and other financial wellness programs
- Educational Assistance Program
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
medical record experiencemedical terminologydata entrysystem documentationclaims reconciliationcost-effectiveness analysisdischarge planning
Soft Skills
verbal communicationwritten communicationinterpersonal communicationteamworkorganizational skillsprofessional conductflexibility
Certifications
AA DegreeCertified Medical AssistantMRT