Referral Specialist

2 weeks ago

Waukegan, United States Lake County Illinois Full time

As the largest human service provider in Lake County, we believe that services must be available without barriers. No residents are turned away due to the inability to pay. We believe in providing services in an environment of mutual respect, free of discrimination or bias. Whether assuring accessible and effective care, impacting policy, or assessing and monitoring risks, the Lake County Health Department and Community Health Center has been an essential part of the public health system in Lake County for 60 years. **We are looking for passionate, qualified team members who can help make a difference in our agency and, most importantly, in our community.**

**Currently, you must reside in Illinois or Wisconsin to work for the Lake County Health Department.** Any offer of employment is conditioned on the successful completion of a background screening, drug and alcohol testing and may include a pre-employment medical exam.
- The Lake County Health Department and Community Health Center is an Equal Opportunity Employer. We evaluate qualified applicants without regard to race, color, religion, sexual orientation, gender identity or gender expression, national origin, disability, veteran status, and other protected characteristics._
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- The **Referral Specialist** is a valuable member of our Health Care Operations Team who is responsible for coordinating referral and prior authorization processes for assigned Patient-Centered Medical Home (PCMH) teams and their respective patients. Serves as a resource for patients and families to ask questions and assists in solving potential issues related to the healthcare system (e.g., assistance with providing transportation services information or prescription assistance). The Referral Specialist consistently provides the highest level of customer service over the telephone.

**Employment in this position is contingent upon continued grant funding beyond December 31, 2024.**

To be successful in this role, we are looking for someone who
- Ability to manage patient appointments, records, and communications efficiently within a clinical setting.
- Strong understanding of medical terminology and clinic procedures to assist healthcare providers and patients efficiently.
- Excellent organizational skills to maintain accurate and up-to-date patient information and clinic schedules.
- Proficiency in using electronic health records (EHR) systems and other clinic management software.
- Demonstrated ability to provide compassionate and professional customer service to patients and their families.

**Schedule: 37.5 Hours per Week**
**Monday - Friday from 8 am - 4 pm with a 30-minute lunch break.**

**Essential Functions**:

- Coordinates all referral requests and follows up on necessary documentation.
- Assists in ensuring that referrals are addressed promptly.
- Assists the PCMH team in obtaining prior authorizations as required by the patient’s insurance company.
- Coordinates obtaining results from all referrals.
- Documents and informs patient of referral, prepares any required forms, and transmits the required information to external providers and/or insurance companies.
- Determines patient’s eligibility for the uninsured specialty referral payment program.
- Schedules patients for appointments, and follow-up appointments, tracks results and recommendations.
- Establishes and maintains cooperative relationships with Lake County Health Department and Community Health Center (LCHD/CHC) staff, insurance companies, local hospitals, physicians, and other health care providers to facilitate continuity of care for LCHD/CHC’s clients.
- Accurately performs data entry of program-related data and information in the appropriate computer systems.
- Documents interactions, i.e., client visits, services provided, phone calls, written correspondence, and communication with patients in patient’s EHR.
- Reports all unusual occurrences that may involve the safety and well-being of the clients/patients and co-workers, directly to supervisor and/or Safety Officer.
- Develops and maintains a working knowledge of individual Emergency Preparedness roles.

**Knowledge Skills Abilities and Education Required**:

- High School diploma or GED required; some college preferred.
- Previous experience in a medical office with a thorough understanding of Medicaid, Medicare, Managed Care Organizations, and PPOs preferred.
- Data entry and basic computer skills required.
- Ability to work on weekends, holidays, and overtime as assigned.
- Bilingual (English/Spanish) preferred.

Pay: $18.14 - $20.71 per hour

Expected hours: 37.5 per week

**Benefits**:

- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Tuition reimbursement
- Vision insurance

Weekly day range:

- Monday to Friday

**Experience**:

- Insurance verification: 1 year (preferred)

Ability to Commute:

- Waukegan, IL (required)

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