Referral Specialist - Chicago Archer - Adventist Health Partners
Location: Chicago, Illinois
Internal Number: 22032047
You are required to upload resume, licensure/certification with your application.
All the benefits and perks you need for you and your family:
Benefits from Day One for FT/PT positions
Paid Days Off from Day One for FT/PT positions
Student Loan Repayment Program for FT/PT positions
Whole Person Wellbeing Resources
Mental Health Resources and Support
Debt-free Education (Certifications and Degrees without out-of-pocket tuition expense)
Our promise to you:
Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
Location: 6084 S. Archer. Ave Chicago
The role you’ll contribute:
The Referral Specialist is responsible for selecting, authorizing, and scheduling appointments and/or procedures for patients who have been referred by our providers. They must ensure that accurate medical record information is given regarding the patient and that the pertinent payer information is obtained and correct. This position requires the ability to multitask, medical terminology familiarity, ability to read and understand insurance cards, ability to read and understand the patients’ medical record, excellent verbal and written communication skills. Customer service skills are a must. Working knowledge of a physician office and the workflow of a patient through the office.
The value you’ll bring to the team:
Maintains professionalism in stressful situations
Professional appearance in accordance with dress code standards
Demonstrates a positive collaborative manner with team members.
Works well across department boundaries.
Honors patient dignity, privacy and confidentiality and respect for human diversity.
Clear and concise communication amongst coworkers, patients, and physicians.
Adheres to Human Resources Policy of Standards and Conduct at all times.
Does Not Use Work Time to handle Matters of “Personal” Nature.
Consistently works what is needed to stay up to date on referral orders received so standard of care is achieved. Department will develop and communicate productivity expectations.
Incorporates patient, physician, customer needs and concerns into decision-making and organizational action.
Obtain out-of-network benefits if necessary
Maintains referral integrity to ensure accuracy and efficiency in the referral process to minimize leakage outside of the system.
Checks inbox frequently throughout the day, by sorting authorizations/denials and/or requests for medical record documentation for patients
Check orders for correct insurance, diagnosis, CPT procedure codes, location and physician’s signature.
Work with to obtain retro authorizations or recoding of procedures
Assists patients with questions, issues and referral updates.
Communicates patient concerns/questions to providers and clinical staff through EHR.
Communicates Insurance denials to physicians to redirect the patients care plan or provide information for a PEER to PEER evaluation to be done with the provider and a provider with the insurance company.
Knowledge of pre-certification/pre-authorization requirements for insurance companies/HMO/PPO.
Ability to read, understand and follow oral and written instruction by provider requesting order(s).
Uses time effectively and always works to maximum productivity.
KNOWLEDGE AND SKILLS REQUIRED:
EDUCATION AND EXPERIENCE REQUIRED:
High School Grad or Equiv and 1+ years’ experience
•Associate degree or Graduate of a Technical School
At AdventHealth, Extending the Healing Ministry of Christ is our mission. It calls us to be His hands and feet in helping people feel whole. Our story is one of hope — one that strives to heal and restore the body, mind and spirit. Our more than 80,000 skilled and compassionate caregivers in hospitals, physician practices, outpatient clinics, urgent care centers, skilled nursing facilities, home health agencies and hospice centers are committed to providing individualized, wholistic care.