Referral Specialist Job at Advocate Health Care (Park Ridge)

Referral Specialist

Advocate Health Care

Location:
United States , Park Ridge

Category:
Health and Beauty

Contract Type:
Not provided

Salary:

21.85 - 32.80 USD / Hour

Save Job

Apply Position

Job Description:

Full-time Referral Specialist position at AMG Park Ridge 1775 Ballard MOB. Responsible for the centralized referral process, working with members, physicians, specialists, and managed care organizations. Involves coordination of discharge planning, claims reconciliation, vendor authorization, and member/physician education. Requires excellent communication and organizational skills, with a schedule of rotated hours.

Job Responsibility:

Management and navigation of the centralized referral process
Works in all aspects of centralized referral process, including processing referrals to members, physicians and specialists
Generates necessary correspondence or calls to members, physicians and office staff, managed care organizations or vendors requesting additional information
Communicates with appropriate staff and members regarding follow-up status of referrals
Works with UM staff to file, prepare correspondence, data entry, system documentation and other medical management related activities
Reconciles and investigates the daily pended claims report to ensure the proper payment of claims in a timely manner
Utilizes the pended claims report to recognize areas of opportunity to provide outreach to members
Coordinates the initial referral and renewal of home care, DME and disposable supplies under the supervision of RN for the outpatient population
Evaluates the cost-effectiveness of DME purchase versus rental
Logs member or physician complaints related to ancillary vendors as well as investigates and documents follow-up of complaints
Responsible for the coordination and monitoring of discharge planning to provide cost effective care and quality outcomes to members
Works with the Hospital Care Manager to coordinate discharge planning referral needs when indicated
Provides authorization of contracted vendors for home health, DME, Skilled Nursing Facilities, and ambulance referrals
Generates referral authorization for in network specialists as well as diagnostic and imaging requests
Documents in IDX the appropriate referral information in a timely fashion
Is responsible for being available telephonically in order to provider referral authorization in a timely fashion to the Hospital Care Manager
Acts as a resource in the education of physician office staff on referral procedures, AHP policies and procedures, and benefit plan limitations
Acts as a resource to customers and assists in the resolution of referral, claim, and eligibility issues
Communicates with the AMG Case Manager, Supervisor, Manager, Director, other health care professionals, and various staff in a positive fashion
Verify eligibility for members including coordination of benefits and third party liability, benefit coverage levels, and problem resolution
Identifies and maintains appropriate communication with Supervisor regarding problems and observations in the course of daily operations

Requirements:

AA Degree or equivalent
3-4 years experience in a managed care organization, hospital or physician’s office
Medical record experience preferred and/or medical terminology
Good verbal and written communications skills
Excellent interpersonal communication skills
Ability to work as a team member
Good computer keyboard proficiency
Good organizational skills
Ability to handle difficult calls and maintain professional conduct
Willingness to be flexible with job responsibilities
Certified Medical Assistant preferred
MRT preferred
Ability to work under stressful conditions
Ability to handle stress and high workload volumes
Flexible with work assignments
Ability to communicate denial of services to members and providers
Ability and willingness to be cross-trained in all referral specialist activities
Ability to lift up to 35 pounds without assistance

Nice to have:

Medical record experience
Certified Medical Assistant
MRT

What we offer:

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program
Opportunity for annual increases based on performance
Premium pay such as shift, on call, and more
Incentive pay for select positions

Additional Information:

Job Posted:
January 31, 2026

Expiration:
February 03, 2026

Employment Type:

Fulltime

Work Type:

On-site work

Advocate Health Care - All Job Offers

Job Link Share:

Referral Specialist

Advocate Health Care

Location:
United States , Park Ridge

Category:
Health and Beauty

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:
January 31, 2026

Expiration:
February 03, 2026

Looking for more opportunities? Search for other job offers that match your skills and interests.

Similar Jobs for Referral Specialist

RN Clinical Care Guide

RN Clinical Care Guide

Senior Speech & Language Therapist

Referral Specialist Manager

Plumbing Lecturer

Patient Care Coordinator

Health Navigator

Health Navigator

Referral Specialist

Advocate Health Care

Location:United States , Park Ridge

Category:Health and Beauty

Contract Type:Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:January 31, 2026

Expiration:February 03, 2026

Looking for more opportunities? Search for other job offers that match your skills and interests.

Similar Jobs for Referral Specialist

RN Clinical Care Guide

RN Clinical Care Guide

Senior Speech & Language Therapist

Referral Specialist Manager

Plumbing Lecturer

Patient Care Coordinator

Health Navigator

Health Navigator

Location:
United States , Park Ridge

Category:
Health and Beauty

Contract Type:
Not provided

Job Posted:
January 31, 2026

Expiration:
February 03, 2026