IL Referral Processing specialist - Wed -Sunday

Full-time - Entry Level

Oak Brook, IL

Hospitals

About the position

The IL Referral Processing Specialist is responsible for supporting the day-to-day operations of the Customer Service Center, primarily focusing on the triaging and processing of home health referrals. This role requires exceptional customer service skills, knowledge of medical insurance verification, and the ability to work both remotely and in-office as needed. The position involves maintaining effective communication with referral sources and ensuring adherence to company policies and guidelines.

Responsibilities

• Provide triaging of home health referrals from various sources with exceptional customer service.
• Assemble referral information in the home health electronic medical record (EMR).
• Process referrals in a timely and accurate manner to maintain high performance levels.
• Screen and troubleshoot phone calls from referral sources, routing concerns appropriately.
• Order and maintain office supplies and equipment as needed.
• Assist with report monitoring and follow-up on pending patients.
• Maintain effective communication with referral sources, physicians, and intake RNs.
• Maintain knowledge of all insurance plans including Medicare, Medicaid, and Managed Care procedures.
• Identify insurance coverage and benefits available to patients, including out-of-pocket costs.
• Determine if payer's coverage requirements are met for services and resolve eligibility issues.
• Coordinate with staff for Transfer of Care documentation.
• Follow standardized workflows to support referral processing goals and standards.
• Participate in regular huddle meetings to track work completion and productivity.
• Build and maintain relationships with other departments to improve effectiveness.
• Adapt to changing business needs and cross-train within the department.

Requirements

• High School diploma or equivalent.
• 2 years of experience in a medical office setting.
• Call center experience is a plus.
• Knowledge of medical terminology and the healthcare industry.
• Knowledge of Medicare/Medicaid and other third-party payers.
• Strong communication skills, both oral and written.
• Ability to work effectively in a team environment.
• Ability to maintain confidentiality and make rational decisions.
• Strong interpersonal skills and ability to prioritize work.
• Competent in Microsoft Office, Word, and Excel.

Nice-to-haves

• Experience with EPIC software.
• Ability to work flexible hours.
• Experience in a call center environment.

Benefits

• Health insurance coverage.
• Paid time off for holidays and vacation.
• Flexible scheduling options.