Referral Coordinator

Wheaton, IL | Job ID: 56276

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Job Description

Are you looking for a new opportunity to grow your existing skillset while also gaining valuable experience to grow your own career? Our client, a nationally recognized Healthcare Provider, rewards teamwork, quality and innovation with opportunities for growth and development. A leading training program giving you the tools you need to succeed has been put in place to make sure your new opportunity will be off to a fantastic start! If you are looking for a career in an organization that is a leader in healthcare industry then this position is for you!

Our client is looking for several Referral Coordinator because the amazing growth within its healthcare organization! The ideal past experience would be working with physicians and clinical staff in a medical or clinical setting and a person who thrives in a fast paced, production oriented work environment is also preferred!


Job Functions of Referral Specialist:

  • Contacts review organizations and insurance companies to obtain prior approval requirements and submit appropriate documentation
  • Verifies member eligibility and basic benefit coverage levels including obtaining information on coordination of benefits and third party liability as appropriate
  • Receives and documents, telephonic, and electronic requests for referrals from Primary Care Physicians, Specialists and Ancillary providers through computerized work que
  • Maintains a current working knowledge of all Health Plan carrier requirements for referral request authorizations and approval path requirements
  • Per referral guidelines evaluates each referral request to ensure the referral request including codes, place of service, service type, provider and all required medical information is available for submission to insurance carriers
  • Investigates and obtains from providers, missing medical information required for referral submissions
  • Performs data entry/processing of referral requests through the EPIC system, and edits referral notes with appropriate information as outlined per department procedures
  • Functions as a resource to physician/provider offices regarding steerage, referral process questions and education on Health Plan authorization submission requirements


Qualifications/Requirements for Referrals Specialist:

  • No less than 2 years of experience in medical office scheduling and verifying patient insurance benefits
  • Working knowledge and understanding of the medical insurance industry and health plans
  • Strong proficiency computer navigation skills, with basic Microsoft Office/Outlook skills
  • Medical Terminology Knowledge required
  • Ability to Type  35 wpm

Kevin Donovan
Project Manager, LaSalle Network

Keywords and Related Terms: patient access, patient service, medical scheduler, insurance verification, EOB, call center, inbound calls, outbound calls, epic

LaSalle Network is an Equal Opportunity Employer, m/f/d/v.

LaSalle Network is the leading provider of professional staffing and recruiting services. LaSalle has worked with more than 10,000 companies, ranging from Fortune 500s to start ups. With units specializing in accounting and finance, administrative, marketing, executive search, technology, sales, supply chain, healthcare revenue cycle, call center, and human resources, LaSalle serves companies of all sizes and across all industries.