Referral Specialist / Him Lead-Full Time

American Addiction Centers•Chicago, IL

10d•$22 - $33•Onsite

About The Position

This is a full-time position requiring 40 hours per week. The role involves coordinating patient care needs for high-risk patients, managing the referral process, and overseeing health information operations. The position requires maintaining good workflow for Health Information associates, training them, and ensuring compliance with medical records department protocols. It also involves backing up various medical records duties as needed.

Requirements

Completion of an LPN, Medical Assistant program, or equivalent experience.
Successful completion of certification exam for CMA or licensure as an LPN.
3-5 years experience in ambulatory/ medical office.
Clinically appropriate skills.
Ability to communicate clearly and effectively in caring manner.
Strong interpersonal & customer relations skills.
Good verbal and written communication skills.
Ability to work as a team player.
Good organizational skills.
Good problem-solving skills.
Ability to handle difficult calls and maintain professional conduct.
Flexible.
LPN Licensure or Medical Assistant Certification.
Current CPR certification.
Knowledge of Universal precautions, Hazadous Waste procedures.

Responsibilities

Coordinates the patient care needs for high risk patients (including diabetes and preeclampsia). Arranges for appropriate referrals and paperwork for specialty physician care, diabetic teaching and nutrition education, home visits, durable equipment needs, etc.
Responsible for coordination of managed care process
Handles the referral processing activities from the physician office side. This includes all the paperwork required for working within the established PHO procedures.
Works through eligibility and denial issues on behalf of the patient and physician.
Identifies and refers appropriate patients for disease management/case management programs.
Responsible for obtaining needed information to get needed referrals
Initiates the medical necessity review process as appropriate with the support of the physician.
Acts as a resource (advocate) for patients in working through the managed care process.
Handles the pre-certification process.
Continues to educate providers and clinical staff of managed care updates
Maintain current skill verification specific to their practice.
Maintain current CPR certification.
Attends in-service and other professional development opportunities.
Maintains CMA re-certification as required.
Responsible for maintaining good work flow for the Health Information associates by scheduling them appropriate to meet budget FTE and assigning assignments.
Responsible for training all Health Information associates and ensures accuracy and completeness of all health information tasks performed by associates.
Updates and reviews compliance of protocols set up for the Family Practice Center Medical Records department.
Responsible for maintaining Chart Tracking system in IDX.
Responsible for all Health Information being requested for Release.
Responsible for forwarding inactive charts to off-site storage area.
Continues to inform and educate clinical staff and providers of health information education (ie: HIPPA)
Back up support as needed for: misc filing, pulling charts, answer phones and performs other Medical Records duties assigned (varies based on practice need).

Benefits

Comprehensive suite of Total Rewards
Benefits and well-being programs
Competitive compensation
Generous retirement offerings
Programs that invest in your career development
Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program