Full Cycle Medical Referral Specialists
Company: Managed Care Staffers
Location: Downers Grove
Posted on: January 12, 2021
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Job Description:
Full Cycle Medical Referral Specialists: Downers Grove, IL; Long
term contractOur client, a very large physician group with a
management office in Downers Grove, is seeking multiple Full Cycle
Referral Specialists on a temporary (possibly temp-to-hire) basis.
SUMMARY OF POSITION--- This position is not verifying eligibility!!
It is full cycle referral processing --- Production expectations
30-35 per day (150-175/week)--- Expect referrals to be processed in
24-48 hours--- Training will occur the first week of employment---
Full cycle referral processing includes the following steps ---
Initiating cases & confirming demographic information--- Confirming
ICD-10 and CPT codes (must be familiar with medical terminology)---
Reaching out to the health plans to secure
approval/authorization--- Transmitting the authorization to the
physicianKNOWLEDGE SKILLS AND ABILITIES:--- High School diploma
required; College Education preferred --- Strong customer service
focus & communication skills--- Working knowledge of Epic system
preferred --- Working knowledge and understanding of the medical
insurance industry and health plans This is a full-time, temporary
position that will work from 8:30am-5:00pm. If you or anyone you
know is interested, qualified and available please email a r--sum--
to us for immediate consideration.Job Requirements:ESSENTIAL DUTIES
AND RESPONSIBILITIES:--- Receives and documents, telephonic, and
electronic requests for referrals from Primary Care Physicians,
Specialists and Ancillary providers. --- 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. --- 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. --- Performs data entry/processing of referral requests
through the EPIC system (Tapestry Module)
Keywords: Managed Care Staffers, Downers Grove , Full Cycle Medical Referral Specialists, Other , Downers Grove, Illinois
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