Referral Coordinator- ACCESS Genesis

ACHNDes Plaines, IL

About The Position

Work with Payors/Plans to process referrals/authorizations to completion according to policy and procedure. Assist Access Clinic providers/staff in identifying appropriate in-network providers for referred services. Assist patients with questions regarding referrals. Coordinate with other departments and facilities to ensure appointments are scheduled and patients have received the necessary information for their appointment(s). Work/address the referrals that remain open to determine if patient received the referred services. Contact Referred to provider to obtain consultation notes. Contact patients per established policy and procedure to ensure they receive referred services. Close referrals per established policy and procedure. Build and maintain relationships with Payor/Plan representatives and ACCESS clinic providers and staff; act as a resource to answer questions and solve problems. Maintain accurate information regarding which external providers are contracted with each Payor/Plan. Monitor for delays in the prior authorization process and works with the Prior Authorization Department to ensure timely scheduling. Monitor referral phases to maintain compliance. Monitor referral dashboards and work queues daily.

Requirements

  • High school diploma or GED required
  • Minimum 1-year experience in a clinical office or health care environment in patient registration, referrals, medical assisting or customer service required.
  • 1-year EHR Systems experience
  • Beginning proficiency Microsoft Office Suite (Word, Excel, Outlook)

Nice To Haves

  • EPIC a plus
  • Bilingual English/Spanish a plus

Responsibilities

  • Process referrals/authorizations to completion according to policy and procedure.
  • Assist Access Clinic providers/staff in identifying appropriate in-network providers for referred services.
  • Assist patients with questions regarding referrals.
  • Coordinate with other departments and facilities to ensure appointments are scheduled and patients have received the necessary information for their appointment(s).
  • Work/address referrals that remain open to determine if patient received the referred services.
  • Contact referred providers to obtain consultation notes.
  • Contact patients per established policy and procedure to ensure they receive referred services.
  • Close referrals per established policy and procedure.
  • Build and maintain relationships with Payor/Plan representatives and ACCESS clinic providers and staff; act as a resource to answer questions and solve problems.
  • Maintain accurate information regarding which external providers are contracted with each Payor/Plan.
  • Monitor for delays in the prior authorization process and works with the Prior Authorization Department to ensure timely scheduling.
  • Monitor referral phases to maintain compliance.
  • Monitor referral dashboards and work queues daily.

Benefits

  • Tuition reimbursement and student loan forgiveness programs for qualifying individuals
  • Comprehensive healthcare coverage including Medical, Dental, and Vision
  • Generous PTO
  • 403(B) retirement plan and financial resources to help you save and plan for your retirement
  • Life Insurance
  • Opportunity to participate in cross-departmental committees to innovate and transform our care delivery model and our workplace
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