WI Referral Processing Specialist: Full Time
About The Position
Collects and records medical, social and reimbursement data pertinent to patient admission to initiate home care, palliative care and hospice. Screens, documents and processes requests for home health, palliative and hospice services. This includes taking incoming calls, answering customer questions, completing intake forms, processing referral orders within EPIC or faxed referrals and documenting service requests for coordination of care; including promoting company products and service. Collaborates with the nursing team when reviewing and processing physician orders for instructions on patient's plan of care and prior to sending patients to the appropriate patient service department to ensure activities are performed within the scope of practice. Communicates and documents any new, changed, updated information, orders or referrals received within intake to the appropriate persons and/or departments as needed to not compromise the quality of care and safety of patient(s). Responds to inquiries regarding Aurora at Home services and programs. Explains programs and services, in addition to determining if patients meet criteria for Centers for Medicare & Medicaid Services (CMS) certified agency, admission policies and/or referring requests to other community agencies when appropriate. Maintains knowledge of and reference materials of Medicare, Medicaid and third-party payer requirements, payer coverage, guidelines, documentation requirements and insurance related changes or trends.
Requirements
- High School Graduate.
- Typically requires 1 year of experience in a clinical environment.
- Basic medical knowledge.
- Strong verbal and written communication skills a must including experience in data entry, multi-line phone system, and customer service experience.
- Excellent interpersonal skills necessary to interact with internal and external customers.
- Demonstrated ability to work well with physicians and other professionals.
- Proficient computer skills including word processing and electronic mail.
- Must be detail-oriented and have excellent organizational skills.
- Must have working Home internet.
- Must be accessible and able to connect via ethernet cable 100-300Mbps suggested.
Responsibilities
- Collects and records medical, social and reimbursement data pertinent to patient admission to initiate home care, palliative care and hospice.
- Screens, documents and processes requests for home health, palliative and hospice services.
- This includes taking incoming calls, answering customer questions, completing intake forms, processing referral orders within EPIC or faxed referrals and documenting service requests for coordination of care; including promoting company products and service.
- Collaborates with the nursing team when reviewing and processing physician orders for instructions on patient's plan of care and prior to sending patients to the appropriate patient service department to ensure activities are performed within the scope of practice.
- Communicates and documents any new, changed, updated information, orders or referrals received within intake to the appropriate persons and/or departments as needed to not compromise the quality of care and safety of patient(s).
- Responds to inquiries regarding Aurora at Home services and programs.
- Explains programs and services, in addition to determining if patients meet criteria for Centers for Medicare & Medicaid Services (CMS) certified agency, admission policies and/or referring requests to other community agencies when appropriate.
- Maintains knowledge of and reference materials of Medicare, Medicaid and third-party payer requirements, payer coverage, guidelines, documentation requirements and insurance related changes or trends.
Benefits
- Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:
- Compensation Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training Premium pay such as shift, on call, and more based on a teammate's job Incentive pay for select positions Opportunity for annual increases based on performance
- Benefits and more 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
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
11-50 employees
