Referral Specialist jobs in Waukegan, IL

Referral Specialist processes insurance pre-verification for hospital admissions or specialty service office visits. Gathers pertinent information from patients, insurance carriers, financial counselors, and other staff to confirm the patient's financial obligations for services. Being a Referral Specialist acts as a liaison between hospitals, clinical staff, health plans, providers, and patients to process referrals. Verifies insurance coverage and obtains required authorizations when necessary. Additionally, Referral Specialist documents referrals, communications, actions, and other data in an information management system. Generates and distributes all applicable forms, notifications, and paperwork. Requires a high school diploma. Typically reports to a supervisor. The Referral Specialist works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. To be a Referral Specialist typically requires 1-3 years of related experience. (Copyright 2024 Salary.com)

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Prior Authorization/Referral Specialist
  • Froedtert South, Inc.
  • Kenosha, WI FULL_TIME
    • POSITION PURPOSE
      • A Prior-Authorization/Referral Specialist is responsible for determining insurance eligibility/benefits and ensuring pre-certification (authorization/referral) requirements are met for both the facility and professional services. The Prior-Authorization/Referral Specialist provides detailed documentation and communication with both payors and clinicians to obtain prior-authorizations. Obtains clinical information to support medical necessity.
    • MINIMUM EDUCATION REQUIRED
      • High School or GED
    • MINIMUM EXPERIENCE REQUIRED
      • 1-3 years
    • LICENSES / CERTIFICATIONS REQUIRED
      • Formal education beyond high school in Business or Healthcare or equivalent experience preferred.
    • KNOWLEDGE, SKILLS & ABILITIES REQUIRED
      • Experience in prior authorization/referrals, patient registration, insurance verification and health insurance plans.
      • Knowledge on online insurance prior-authorization process and working with various payors.
      • Excellent customer service and computer skills.
      • Familiarity with Medical Terminology.
      • Demonstrated ability to efficiently organize work, while maintaining a high level of accuracy and productivity.
      • Knowledge of ICD-10, CPT and HCPC codes and use.
      • Familiarity with internet, email and Microsoft Office.
      • Effective written and verbal communication skills required.
    • PRINCIPLE ACCOUNTABILITIES AND ESSENTIAL DUTIES
      • Verifies eligibility and benefit levels to ensure adequate coverage for identified services.
      • Obtains pre-certification, authorization and referral approval for required services for both the facility and professional services.
      • Calculates "billable units" for medication as identified by the payer rather than utilizing patient visits.
      • Manages and resolves assigned departmental workqueues.
      • Coordinates and supplies information to the review organization (payer) including clinical information and/or letter of medical necessity for determination of benefits. Coordinates peer-to-peer reviews, when required.
      • Communicates with patients, clinicians, financial counselors and other as necessary to facilitate the authorization process.
      • Completes accurate documentation in healthcare software.
      • Completes inpatient notification to all payers using their preferred method within 24 hours of admission.
      • Ensures timely and accurate insurance authorizations/referrals are in place prior to services being rendered.
      • Notifies patient/department when authorization/referral has not been obtained prior to service date.
  • 22 Days Ago

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Clinical Referral Specialist I
  • Advocate Aurora
  • Racine, WI FULL_TIME
  • Major Responsibilities:Reviews work queues to identify unscheduled ordered services and connects with the patient to schedule the appropriate service.Schedules appointments including complex specialty...
  • 8 Days Ago

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Referral Coordinator
  • Vista Health System
  • Waukegan, IL FULL_TIME
  • Apply Now at Vista Health System and begin working and servicing patients in our community! Invest your time in providing quality care for the communities we serve! Vista Health System is a community ...
  • 3 Days Ago

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Veterinary Technician
  • Wisconsin Veterinary Referral Center - Kenosha
  • Racine, WI FULL_TIME
  • TAKE YOUR CAREER TO THE NEXT LEVEL! Wisconsin Veterinary Referral Center (WVRC) by Ethos Veterinary Health in Racine, Wisconsin is looking to hire a Full-time ER Veterinary Technician. Shift details =...
  • 15 Days Ago

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Medical Oncologist in Racine/Kenosha WI
  • Wisconsin Veterinary Referral Center - Kenosha
  • Kenosha, WI FULL_TIME
  • Wisconsin Veterinary Referral Center (WVRC) [http://www.wvrc.com/] is seeking a BOARD-CERTIFIED OR RESIDENCY TRAINED MEDICAL ONCOLOGIST TO START UP AND DEVELOP THE ONCOLOGY SERVICE AT OUR SPECIALTY HO...
  • 1 Month Ago

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Process Technician ($500 Sign-On/Referral Bonus!)
  • CEO Inc
  • Antioch, IL FULL_TIME
  • 2nd Shift, M- F$25-$30/hr depending on experienceWould like someone who has experience working on Lyle Machines (its a brand of plastics machinery)*Training will most likely be on 1st or 2nd$500 Sign-...
  • 15 Days Ago

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0 Referral Specialist jobs found in Waukegan, IL area

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Project Manager - Expert
  • Aditi Consulting
  • Chicago, IL
  • Summary: The Client Service & Implementation (CS&I) Change Lead role is being created within the Change Management funct...
  • 4/26/2024 12:00:00 AM

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COP Specialist
  • Tower Communications Expert, LLC
  • Willowbrook, IL
  • Job Description Company Background: Tower Communications Expert (TCE), is a leader in the telecommunications industry of...
  • 4/26/2024 12:00:00 AM

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Subject Matter Expert (SME) for Health Administration (Remote/Hybrid) - (Contractor)
  • Confidential
  • Chicago, IL
  • Job Summary: We are actively searching for a Subject Matter Expert (SME) with a comprehensive background in health admin...
  • 4/25/2024 12:00:00 AM

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Network Infrastructure Subject Matter Expert (SME)
  • Vtech Solution
  • Chicago, IL
  • Job Description Job Description Job Details:The Network Infrastructure SME shall have the following qualifications and d...
  • 4/23/2024 12:00:00 AM

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Freelancing Expert - Media Buyer
  • Fud, Inc.
  • Chicago, IL
  • Fud, the "World's First Social Hustling Community" is seeking a Freelancing Expert - Media Buyer to join our team. As a ...
  • 4/23/2024 12:00:00 AM

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Factory Management Expert
  • Bird Buddy
  • Woodstock, IL
  • Factory Management Expert Location: Illinois / Mexico (Travel Required) Duration: 3 Months, with potential extension to ...
  • 4/22/2024 12:00:00 AM

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Product Expert -0024
  • American Sale
  • Lake Zurich, IL
  • Job Description Job Description Job Opportunity: Store Associate/ Product Expert at American Sale- Bring the Fun Home! A...
  • 4/22/2024 12:00:00 AM

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Product Expert -0024
  • American Sale
  • Carol Stream, IL
  • Job Description Job Description Job Opportunity: Store Associate/ Product Expert at American Sale- Bring the Fun Home! A...
  • 4/22/2024 12:00:00 AM

Waukegan /wɔːˈkiːɡən/ is the largest city in and the county seat of Lake County, Illinois, United States, a part of the Chicago metropolitan area. The city is located 35 miles north of the Loop and 10 miles south of the Wisconsin state border, approximately halfway between Chicago and Milwaukee. As of the 2013 United States Census estimate, the city has a population of 88,826, which makes it the ninth most populous city in Illinois. Waukegan is a predominately working-class community with a size-able middle-class population. Waukegan is located at 42°22′13″N 87°52′16″W / 42.37028°N 87.87111...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Referral Specialist jobs
$40,135 to $49,272
Waukegan, Illinois area prices
were up 1.8% from a year ago

Referral Specialist in Terre Haute, IN
This position serves as the centralized intake for all internal referrals to core service programs.
December 12, 2019
Referral Specialist in Albany, NY
The Information and Referral Specialist 1 is the entry level classification which gathers information on community resources and utilizes a broad knowledge of the community resource network to make appropriate referrals to service providers.
December 01, 2019
Referral Specialist in Florence, AL
As a Referral Specialist you will execute patient insurance referrals, consultations, and diagnostic procedures relating to Kadlec Clinic.
January 14, 2020