Sr. Referral Specialist - Oncology Infusion Therapy

Overview

Sr. Referral Specialist - Oncology - Hybrid/Lisle

Position Highlights:

• Full Time: 40 Hours/Week
• Hours: Monday - Friday 8:00am - 4:30pm
• Location: Hybrid/Lisle, IL
  
  

Benefits:

• Comprehensive medical, dental, and vision benefits that include healthcare navigation assistance and medical coverage at 100% (after deductible) when utilizing a Duly provider.
• Employer provided life and disability insurance.
• $5,250 Tuition Reimbursement per year.
• Immediate 401(k) match.
• 40 hours paid volunteer time off.
• A culture committed to Diversity, Equity, and Inclusion (DEI) and Social Impact.
• Up to 12 weeks parental leave at 100% pay and a financial benefit for adoption and surrogacy for non-physician team members once eligibility requirements are met.
  
  

Responsibilities

Under the direction of the leadership, the Senior Referral Specialist is responsible for a high volume of incoming calls and complex referral/authorization requests from Patients and Physician Offices. The Senior Referral Specialist is responsible for processing internal and external referrals requests which includes but is not limited to, obtaining and submitting medical records, verification of eligibility, obtaining benefit coverage determinations, providing network steerage and referral issue resolution. These activities are designed to support the delivery of quality, appropriate health care and health care promotion for all patients. This position is primarily Telephonic, computer driven, and office based.

Qualifications

EDUCATION and / or CERTIFICATION/LICENSURE:

• High School Diploma
  
  

EXPERIENCE:

• 3-5 years or healthcare experience, preferably in working with referrals and processing benefit investigation and authorizations with health plans
• Working knowledge of electronic medical records, Epic system preferred
• Experience in a fast pace, telephonic, production oriented and metric driven work environment
• Experience with phone queues and work queues
• Able to challenge health plan medical directors and provide clinicals over the phone to prevent delays with authorizations
• Experience in the reconsideration/appeal process with commercial and government payers
• Knowledge with Medicare medical policies and CMS guidelines
  
  

The compensation for this role includes a base pay range of $17.67-26.50, with the actual pay determined by factors such as skills, experience, education, certifications, geographic location, and internal equity. Additional compensation may be available through shift differentials, bonuses, and other incentives. Base pay is only a portion of the total rewards package.