Referral​/Authorization Coordinator

OAK Orthopedics is looking for a full-time Referral/Authorization Coordinator for our Bourbonnais location. The Coordinator facilitates the administration of medical services by evaluating referral requests for eligibility, benefit determination, preferred provider networks, level of care, and authorization of referral requests.

• Authorizes referrals and applies criteria when necessary.
• Meets or exceeds departmental productivity targets on a weekly basis.
• Maintains files and records of referral/authorization activity.
• Demonstrates initiative, motivation, and resourcefulness in day-to-day operations.
• Utilizes medical necessity criteria, scope of benefits, and health plan criteria.
• Works aggressively with physicians and physician office staff to obtain necessary authorization related to referral requests.
• Assists with cross coverage within the referral/authorization team as assigned.
• Participates in staff meetings.
• Provides customer service and maintains professional interaction with physicians, offices, members, and health plan staff.
• Organizes activities according to priority and coordinates with others to achieve goals.
• Takes responsibility for assigned work and follows through.
• Opens to new ideas, adapts to changing needs, and pursues positive outcomes.
• Collaborates with others, contributes to the team, and encourages participation and commitment.
• Performs other duties as assigned by the manager.

• Two-year experience in the medical or health insurance field.
• One year of prior referral and/or precertification experience in an office or health plan setting preferred.
• Effective communication, written and oral.
• Ability to multitask in a fast-paced environment.
• Independent work style.
• Typing skills.
• CPT and ICD-9 coding familiarity.
• Knowledge of Microsoft Office (Word, PowerPoint).

Salary $19-25 per hour

Employment Type Full-time