Referral Specialist

Referral Specialist

Location: Carpentersville/Woodstock
Full-Time
Pay Range: $17.00-$18.00 per hour

About Aunt Martha's Health & Wellness

At Aunt Martha's Health & Wellness, we boldly commit to supporting the well-being of our communities, ensuring equity in access, and delivering exceptional care inspired by a culture of innovation. We take a responsible approach to creating environments that allow us to do what we do best-provide healthcare and wellness services to those who need them most.

Position Overview

The Referral Specialist plays a vital role in ensuring patients receive timely access to specialty care and medical services by coordinating referrals, processing medical orders, and maintaining communication with patients, providers, hospitals, and health plans.

This position is responsible for reviewing medical orders, verifying insurance eligibility, obtaining prior authorizations, and monitoring referral status to ensure services are completed efficiently. The Referral Specialist serves as a key liaison between patients, providers, and insurance carriers while delivering exceptional customer service and supporting positive patient outcomes.

Key Responsibilities

Referral Coordination & Patient Support

• Review and process referrals, diagnostic orders, surgery requests, and transportation requests.
• Verify insurance eligibility and ensure referrals meet organizational and payer requirements.
• Obtain prior authorizations as required by health plans.
• Serve as the primary point of contact for patients regarding referral and order status.
• Act as a liaison between patients, providers, specialists, hospitals, and referring agencies to coordinate timely patient care.

Documentation & Medical Records

• Maintain accurate referral documentation within the Athena Electronic Health Record (EHR).
• Scan and upload specialist reports, hospital documentation, and referral communications into patient records.
• Ensure all patient information is documented accurately while maintaining strict HIPAA compliance.
• Maintain ethical standards and patient confidentiality at all times.

Customer Service & Communication

• Deliver exceptional customer service utilizing the AIDET model.
• Communicate referral updates and authorization status to patients by phone and mail.
• Answer incoming telephone calls professionally and route messages appropriately.
• Respond promptly to internal and external customer inquiries while ensuring a positive patient experience.

Administrative Support

• Utilize Athena EHR to document patient information and referral activity.
• Maintain accurate records and complete data entry in a timely manner.
• Attend required meetings, trainings, and complete all Core Curriculum requirements.
• Perform additional duties as assigned to support clinic operations.

Compensation & Benefits

• Competitive hourly pay: $17.00-$18.00 per hour
• Health, Dental, and Vision Insurance
• Life & Disability Insurance
• Paid Vacation, Sick Time, and Holidays
• Retirement Plan
• Employee Assistance Program (EAP)
• Employee Discounts on cell phone plans, restaurants, and more

Qualifications

Required Education & Experience

• High School Diploma or GED required.
• Minimum of six months of experience working in a medical office.
• Proficiency with Microsoft Office applications.
• Strong computer and data entry skills.
• Excellent verbal and written communication skills.

Preferred Skills

• Experience working with Athena or another Electronic Health Record (EHR) system.
• Knowledge of insurance verification, referrals, and prior authorization processes.
• Strong organizational skills with exceptional attention to detail.
• Ability to manage multiple priorities in a fast-paced healthcare environment.
• Bilingual English/Spanish is a plus.

Additional Requirements

• Current driver's license.
• Current automobile insurance.
• Ability to work evenings, weekends, and holidays as needed.
• Commitment to maintaining patient confidentiality and HIPAA compliance.
• Ability to work independently and collaboratively as part of a healthcare team.

Equal Opportunity Employer

Aunt Martha's Health & Wellness is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, disability status, or any other characteristic protected by applicable law.