Department: 10422 IL Home Health Divisional - Patient Access Status: Part time Benefits Eligible: No Hours Per Week: 0 Schedule Details/Additional Information: Must have close to full-time availability for orientation Av…
Skills: Referral processing, Customer service, Medical terminology, Insurance verification, Electronic medical record
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Oak Brook, Illinois, United States · On-site
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Director of Revenue Operations Analytics & Performance Management
Oak Brook, Illinois, United States · On-site
Senior
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Retail Cosmetics Sales Associate - Lancome, Oak Brook Center - Full Time
Oak Brook, Illinois, United States · On-site
$15/hr–$22/hr
Entry level$5.0B raised
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$20/hr–$31/hr
Part-time, Per diem
high school
Paid time off, Health benefits, Dental insurance, Vision insurance, Life insurance, Short-term disability
Posted 5d ago
~40 hrs/week
Remote in Oak Brook, Illinois, United States
Responsibilities
The specialist is responsible for triaging and processing home health referrals while maintaining accurate electronic medical records and insurance verification. They must also collaborate with clinical teams and referral sources to ensure seamless patient care and adherence to company guidelines.
Requirements
Candidates must have a high school diploma and at least two years of experience in a medical office setting. Proficiency in medical terminology and knowledge of Medicare, Medicaid, and third-party payer procedures are required.
Full job description
Department:
10422 IL Home Health Divisional - Patient Access
Status:
Part time
Benefits Eligible:
No
Hours Per Week:
0
Schedule Details/Additional Information:
Must have close to full-time availability for orientation
Available 8:30-5pm M-F with weekend and holiday rotations
Remote Position - must have high speed internet
First day of Orientation will be onsite
Pay Range:
$20.80 - $31.20Major Responsibilities:
A. Provide support to the day-to-day operations of Customer Service Center.
1)Provide triaging of home health referrals from referral sources received telephonically, electronically or by fax with exceptional customer service.
2)Assemble referral information in the home health electronic medical record (EMR) including monitoring interface of data from other electronic systems.
3)Process referrals in a timely, complete, and accurate manner in order to achieve and maintain exceptional levels of performance that includes customer service.
4)Screens and troubleshoots phone calls from referral sources and routes concerns to appropriate department or leadership.
5)Orders and maintains office supplies, forms and equipment as needed.
6)Assist with report monitoring and follow-up on pending patients.
7)Maintains effective communication with referral sources, physicians, home care liaisons and intake RNs to ensure adherence to company policies, guidelines and processes.
8)Maintains knowledge of all insurance plans including Medicare, Medicaid, and Managed Care procedures and guidelines.
When entering referral, correctly identify insurance coverage, investigate and verify sources of reimbursement and make recommendations based on the information obtained.
1)Identify insurance coverage, benefits available, patient's out-of-pocket costs, co-insurance, co-payment and deductible.
2)Determine if payer's coverage requirements are met for services.
3)Follow established department guidelines and procedures to resolve issues related to patient's eligibility coverage, and issues arising from in-network/out-of-network status for patients using Advocate's network.
4)Communicate timely with operations, other patient accounts staff and customer relations regarding eligibility, to facilitate continuity of care with minimal financial risk.
5)Post benefits information in appropriate place as established by workflow.
6)When Transfer of Care is identified coordinate with other staff including clinical and non clinical staff from hospitals or branches to obtain and complete documentation for transfer to Advocate Home Health.
Follows a standardized workflow to support achievement of goals and standards related to referral processing.
1)Interacts with referral sources during referral processing to promote effective communication and monitors adherence to established processes.
2)Partners with clinical staff to assure accuracy and completeness of referrals, follows-up on issues and escalates concerns as appropriate.
3)Adhere to standard operating procedures and maintain expected levels of productivity to assure the best health outcomes for our patients.
4)Follows established scripting for customer service calls and communicating with referral sources.
5)Utilizes critical thinking skills to identify issues and communicate with one up to promote seamless workflow in referral processing.
6)Administers reports and maintains files of correspondence, medical records, and other documentation, as appropriate, to report status and to support workflow.
7)Utilizes multiple electronic and telephony systems.
8)Monitor task reports and respond as needed to process new referrals timely.
9)To reduce turnaround time and re-work adhere to shift productivity and quality expectations as determined by department.
Team Work.
1)Participate in regular huddle meetings with manager and peers.
2)Track work completion, communicate productivity at huddles and identify barriers and successes.
3)Partners with team members on difficult referrals.
4)Participates in peer interviewing process of new candidates.
5)Serves as a preceptor/mentor for new associates and assists with orientation/training
6)Build and maintain relationships with other departments both clinical and non-clinical areas to improve department effectiveness and growth.
7)Adapt to changing business needs, conditions and work responsibilities. Cross-train to multiple roles within the department.
8)Visits referral sources to build relationships and promote communication regarding referral processing requirements.
9)Collaborate with clinical team members to validate/verify accurate and completeness of referral information collected to assure appropriate processing of referrals.
10)Perform all other duties as assigned.
Education/Experience Required:
• HS diploma • 2 years of experience in a medical office setting • Call center experience a plus • Knowledge of medical terminology and health care industry • Knowledge of Medicare/Medicaid and other third party payers.
Knowledge, Skills & Abilities Required:
• Strong communication skills (both oral and written). • Able to work effectively with all colleagues, to ensure the seamless referral processing • Ability to work well in a team environment with a positive attitude • Appreciation of the need for and ability to maintain confidentiality • Rational/logical decision making • Ability to prioritize work and work unsupervised for periods of time • Strong interpersonal skills • Ability to take responsibility for processing referrals within timeframes and responding to queries about Medicare, Medicaid and Managed Care Services. • Competent in the use of a range of software packages including Microsoft Office, Word and Excel (used daily) • Ability to follow through on tasks and communicate between and among team members • Ability to respond to callers professionally and courteously. • Ability to express self clearly and assertively, and work in a busy office.
N/A
Physical Requirements and Working Conditions:
• Independent thinker • High energy, self-starter • Effective communicator • Detail oriented • Work flexible hours • Occasional travel to other Advocate and referral locations as necessary in all weather conditions on all types of roads including expressways
• 10 lbs or less regularly of office supplies/equipment to perform job • 20-50 lbs occasionally (e.g. box of of paper)
This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.
Our Commitment to You:
Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:
Compensation
Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
Premium pay such as shift, on call, and more based on a teammate's job
Incentive pay for select positions
Opportunity for annual increases based on performance
Benefits and more
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
Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview.
About Advocate Health
Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.
Leading nationwide provider of substance use treatment offering a full continuum of care. #FreedomFromAddiction
Industry
Hospitals and Health Care
Company size
1,001-5,000 employees
Founded
2012
Headquarters
Brentwood, Tennessee
LinkedIn followers
32,434
Total funding
$125M
American Addiction Centers (AAC) is a nationwide network of treatment centers, offering a full continuum of care. We take a holistic approach to addiction treatment — by addressing each client as a whole person. We work to consider how factors such as an individual’s lifestyle, environment, health, and co-occurring mental health disorders may play a part in his or her addiction to drugs or alcohol. We use evidence-based treatment approaches to help individuals struggling with substance use and co-occurring mental health disorders to overcome daily struggles and establish a healthy lifestyle.
Our Mission: To restore hope and empower individuals and families impacted by the disease of addiction. United by compassion and a commitment to inclusive care, we provide a foundation for lasting recovery that saves and transforms lives.
Our Vision: To foster a world free from the stigma of addiction, where quality treatment and support are accessible for all.
American Addiction Centers is constantly building our brand and expanding our treatment services to meet the needs of those struggling with substance use and mental health disorders. In order to accomplish this, we need top talented professionals in all departments to help us not only achieve our business goals, but to also continue rescuing those battling addiction. We’d love to have your join our team! See our open positions at americanaddictioncenters.org/careers.
Community Guidelines:
We treat others with respect and communicate with courtesy. We encourage positive engagement and thoughtful dialogue. We do not tolerate defamatory, harmful messages or hate speech, directed at either the company or another individual. We respect the privacy and personal information of our team as well as community members.
We reserve the right to delete or block individuals or users who violate our guidelines.
Offices: 500 Wilson Pike Circle, Suite 360, Brentwood, Tennessee 37027, US · 1171 107th Street, Grand Prairie, TX 75050, US · 2465 E Twain Ave, Las Vegas, NV 89121, US · 12012 Boyette Rd, Riverview, FL 33569, US · 24552 Pacific Park Dr, Aliso Viejo, California 92656, US
Dual DiagnosisMedical DetoxBehavioral Health ServicesLifestyle WellnessResidential Treatmentand Employee Care (EAP & MAP)Health CareAddiction TreatmentPharmaceutical