Referral Specialist- Full-time- Park Ridge

Advocate Aurora Health

Park Ridge, IL, United States
Base: $21.85 - $32.80; bonus/equity: not specified...
Not specified (assumed on-site due to location).
3-4 years managed care experience
Aa degree or equivalent required
Medical terminology knowledge preferred
Advocate Aurora Health is seeking a full-time Referral Specialist in Park Ridge, IL, responsible for managing the centralized referral process, overseeing communication with members and healthcare providers, and ensuring compliance with medical policies. The ideal candidate should have a background in managed care or healthcare settings, along with strong communication and organizational skills

Job Summary

  • This role manages the centralized referral process for Advocate Aurora Health, including processing referrals to members, physicians, and specialists.
  • The incumbent is responsible for coordinating discharge planning, authorizing home health and DME services, and investigating pended claims reports.
  • Advocate Health offers a comprehensive benefits suite including medical, dental, vision, retirement plans, and educational assistance programs.

Matching Summary

Match Score: 85

Advocate Aurora Health is seeking a full-time Referral Specialist in Park Ridge, IL, responsible for managing the centralized referral process, overseeing communication with members and healthcare providers, and ensuring compliance with medical policies. The ideal candidate should have a background in managed care or healthcare settings, along with strong communication and organizational skills.

Salary

Base: $21.85 - $32.80; Bonus/Equity: Not specified; Benefits: Comprehensive suite including PTO, health/welfare, retirement match, and educational assistance

Skills & Requirements

Must-have

  • 3-4 years managed care experience
  • AA degree or equivalent required
  • Medical terminology knowledge preferred
  • IDX system documentation proficiency
  • Claims reconciliation and investigation

Nice-to-have

  • Certified Medical Assistant preferred
  • MRT certification preferred
  • Experience with Evicore Carelon systems
  • Ability to handle difficult calls professionally
  • Knowledge of UHC RadMD and Availity

Key Requirements

  • AA Degree or equivalent
  • 3-4 years in managed care/hospital/physician office
  • Medical record experience preferred
  • Certified Medical Assistant preferred
  • MRT preferred

Work Rights

Not specified

Tailored Resume

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