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Referral Specialist Jobs

Company

Lake County Illinois
Address ,
Employment type FULL_TIME
Salary $17.87 - $20.91 an hour
Expires 2023-10-19
Posted at 9 months ago
Job Description
General Description

The Referral Specialist is responsible for coordinating referral and prior authorization processes for assigned Patient-Centered Medical Home (PCMH) teams and their respective patients. In this role, you will serve as a resource for patients and families to ask questions and assists in solving potential issues related to the healthcare system (e.g., assist with providing transportation services information or prescription assistance) while providing the highest level of customer service over the telephone.

Scheduled Hours: 37.5 hours a week
  • Monday - Friday
This position is funded through the AARPA grant, which expires on March 31, 2024.

Essential Functions

  • Determines patient’s eligibility for the uninsured specialty referral payment program.
  • Schedules patients for appointments, follow-up appointments, track results and recommendations.
  • Prepares correspondence and any other required documentation related to the above position responsibilities.
  • Accurately performs data entry of program-related data and information in the appropriate computer systems.
  • Maintains orderliness and cleanliness of clinic and work area.
  • Performs duties in a prioritized organized and orderly manner to maximize clinic efficiency and productivity.
  • Establishes and maintains cooperative relationships with Lake County Health Department and Community Health Center (LCHD/CHC) staff, insurance companies, local hospitals, physicians, and other health care providers to facilitate continuity of care for LCHD/CHC’s clients.
  • Documents and informs the patient of referral, prepare any required forms, and transmits the required information to external providers and/or insurance companies.
  • Assists the PCMH team in obtaining prior authorizations as required by the patient’s insurance company.
  • Coordinates all referral requests and follows up on necessary documentation.
  • Develops and maintains a basic knowledge of services available at the LCHD/CHC.
  • Documents interactions, i.e., client visits, services provided, phone calls, written correspondence, and communication with patients in patients’ EHR.
  • Participates in quality improvement activities to assess, monitor, and improve program services.
  • Reports all unusual occurrences that may involve the safety and well-being of the clients/patients and co-workers, directly to supervisor and/or Safety Officer.
  • Demonstrates effective oral, written, and electronic communication skills.
  • Coordinates obtaining results from all referrals.
  • Participates in mandatory services and drills, attends staff meetings, and other appropriate educational training offered on a regular basis, for professional development.
  • Develops and maintains a working knowledge of individual Emergency Preparedness roles.
  • Assists in ensuring that referrals are addressed in a timely manner.

Knowledge Skills Abilities and Education Required

  • A high school diploma or GED is required; some college preferred.
  • Bilingual (English/Spanish) preferred.
  • Data entry and basic computer skills are required.
  • Ability to work on weekends, holidays, and overtime as assigned.
  • Previous experience in a medical office with a thorough understanding of Medicaid, Medicare, Managed Care Organizations, and PPOs preferred.

Supplemental Information

As the largest human service provider in Lake County, we believe that services must be available without barriers. No residents are turned away due to the inability to pay. We believe in providing services in an environment of mutual respect, free of discrimination or bias. Whether assuring accessible and effective care, impacting policy, or assessing and monitoring risks, the Lake County Health Department and Community Health Center have been an essential part of the public health system in Lake County for 60 years. We are looking for passionate, qualified team members, who can help make a difference in our agency, and most importantly, in our community.

As a public health department, we believe in the science, data, and power of vaccines, like influenza and COVID-19 vaccines, to protect against and prevent illness. Therefore, we require all Health Department staff to receive the primary series of the COVID-19 vaccine as well as the annual influenza vaccine unless they have an approved medical or religious exemption.

Any offer of employment is conditioned on the successful completion of a background screening, drug and alcohol testing and may include a pre-employment medical exam.

The Lake County Health Department and Community Health Center is an Equal Opportunity Employer. We evaluate qualified applicants without regard to race, color, religion, sexual orientation, gender identity or gender expression, national origin, disability, veteran status, and other protected characteristics. At this time, you must reside in either Illinois or Wisconsin to work for the Lake County Health Department.