Clinical Referral Specialist II

4 days ago


Milwaukee, Wisconsin, United States 223 Aurora Medical Group, Inc. Full time
About the Role

We are seeking a highly skilled Clinical Referral Specialist II to join our team at 223 Aurora Medical Group, Inc. This role is responsible for coordinating patient care, scheduling medical services, and ensuring seamless communication between patients, providers, and caregivers.

Key Responsibilities
  • Review work queues to identify unscheduled ordered services and connect with patients to schedule the appropriate service.
  • Confirm and secure authorization or required pre-certifications for patients to receive specialty consultation or medical services, and close the referral if an authorization is not required.
  • Schedule appointments, including complex specialty appointments, and adhere to appropriate protocols.
  • Communicate with patients about pre and post-appointment instructions, medication guidelines, and other essential information.
  • Provide provider referrals to patients based on ordered medical services and patient preferences.
  • Coordinate scheduling of external referrals with non-Aurora specialists in accordance with Medical Group guidelines.
  • Manage demographic and insurance information, ensuring accuracy and completeness.
  • Document all contact attempts to schedule ordered medical services in the patient's electronic health record.
  • Notify ordering providers through telephone encounters in the electronic health record when ordered medical services are removed.
  • Provide exceptional patient service by problem-solving, documenting patient concerns, and identifying follow-up actions.
  • Maintain knowledge of Medicare, Medicaid, and third-party payer requirements, guidelines, and policies.
  • Manage EPIC In-Basket and requested authorizations across the system.
  • Provide weekly updates to team leads and department leadership on issues, including escalations of in-house provider or caregiver questions.
Requirements
  • High school graduate.
  • Typically requires 2 years of experience in a medical group with focused experience in patient care coordination and scheduling of specialty services.
  • Advanced knowledge of referral management and electronic health record software systems.
  • Excellent communication and problem-solving skills.
  • Ability to work independently and be self-directed.
  • Proficiency in Microsoft Office.
About Advocate Health

Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience, and value-based care. We provide care under the names in Illinois, the Carolinas, Georgia, and Alabama, and in Wisconsin. Our team of 155,000 teammates across 69 hospitals and over 1,000 care locations is committed to providing equitable care for all.



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