Position Highlights:

• Position: Referral Specialist
• Location: Naperville
• Full Time
• Hours: Monday-Friday
• Required Travel: Woodridge Office

What you will need:

• High School Diploma or GED
• Minimum of two years of physician office or physician billing experience
• Minimum of one year of customer service experience
• Working knowledge of medical terminology or coding experience
• Proficient keyboard and computer skills

Preferred Education and/or Experience

• Previous claims processing or insurance company experience
• Excellent keyboarding skills

What you will do:

Reviewing provider orders and/or requesting for patient services and determining appropriate referral, prior authorizations, and pre-certifications process per health plan requirements. Consistently providing the highest level of customer service both on the phone and in person.

• Reviews open status referral report/Epic work queues daily and processes referrals to approved, closed or incomplete status based on established policy.
• Ensures complete and accurate registration, including patient demographic and current insurance information.
• Addresses questions and concerns with patients regarding their referrals and sets guidelines and expectations about the EHV referrals process.
• Utilizes online tools to research criteria to verify insurance coverage and need for preauthorization.
• Communicates professionally with insurance companies, patients, primary care physicians, specialists and/or facilities regarding authorization as needed.
• Works with the provider to ensure the procedure has correct coding and is approved prior to initiation of procedure/test/treatment.
• Establishes, develops and maintains good working relationships with hospital departments, health plan representatives and physician office personnel to ensure timely transfer of information to complete the authorization process and promote goodwill.
• Documents all referral information in Epic.
• Ensures strict confidentiality of all health records, member information and meets HIPAA guidelines.

Benefits:

• Career Pathways to Promote Professional Growth and Development
• Various Medical, Dental, and Vision options
• Tuition Reimbursement
• Free Parking at designated locations
• Wellness Program Savings Plan
• Health Savings Account Options
• Retirement Options with Company Match
• Paid Time Off and Holiday Pay
• Community Involvement Opportunities