Referral Specialist

AUNT MARTHAS HEALTH AND WELLNESS INC•Park Forest, IL

4d•$17 - $18•Hybrid

About The Position

The Referral Specialist plays a vital role in ensuring patients receive timely access to specialty care and medical services by coordinating referrals, processing medical orders, and maintaining communication with patients, providers, hospitals, and health plans. This position is responsible for reviewing medical orders, verifying insurance eligibility, obtaining prior authorizations, and monitoring referral status to ensure services are completed efficiently. The Referral Specialist serves as a key liaison between patients, providers, and insurance carriers while delivering exceptional customer service and supporting positive patient outcomes.

Requirements

High School Diploma or GED required.
Minimum of six months of experience working in a medical office.
Proficiency with Microsoft Office applications.
Strong computer and data entry skills.
Excellent verbal and written communication skills.
Current driver's license.
Current automobile insurance.
Commitment to maintaining patient confidentiality and HIPAA compliance.
Ability to work independently and collaboratively as part of a healthcare team.

Nice To Haves

Experience working with Athena or another Electronic Health Record (EHR) system.
Knowledge of insurance verification, referrals, and prior authorization processes.
Strong organizational skills with exceptional attention to detail.
Ability to manage multiple priorities in a fast-paced healthcare environment.
Bilingual English/Spanish is a plus.

Responsibilities

Review and process referrals, diagnostic orders, surgery requests, and transportation requests.
Verify insurance eligibility and ensure referrals meet organizational and payer requirements.
Obtain prior authorizations as required by health plans.
Serve as the primary point of contact for patients regarding referral and order status.
Act as a liaison between patients, providers, specialists, hospitals, and referring agencies to coordinate timely patient care.
Maintain accurate referral documentation within the Athena Electronic Health Record (EHR).
Scan and upload specialist reports, hospital documentation, and referral communications into patient records.
Ensure all patient information is documented accurately while maintaining strict HIPAA compliance.
Maintain ethical standards and patient confidentiality at all times.
Deliver exceptional customer service utilizing the AIDET model.
Communicate referral updates and authorization status to patients by phone and mail.
Answer incoming telephone calls professionally and route messages appropriately.
Respond promptly to internal and external customer inquiries while ensuring a positive patient experience.
Utilize Athena EHR to document patient information and referral activity.
Maintain accurate records and complete data entry in a timely manner.
Attend required meetings, trainings, and complete all Core Curriculum requirements.
Perform additional duties as assigned to support clinic operations.