Referral Specialist- Health Resources

The Referral Specialistreflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.

Responsibilities:

• Consistently practices Patients First philosophy and adheres to high standards of customer service. This includes setting an example to peers, coworkers, etc. by fostering a team atmosphere.
• Responds to questions and concerns.
• Forwards, directs and notifies Team Lead or Operations Coordinator of extraordinary issues as necessary.
• Maintains patient confidentiality per HIPAA regulations.
• Provides exceptional customer service to consumers which establishes a positive first impression of Northwestern Medicine.
• Exceed all consumer requests and alert management of issues or concerns that require escalation.
• Appropriately triages telephone inquiries requesting medical services and/or physician referral/appointment to determine level of urgency/acuity and type of physician needed for stated problem.
• Maintains sufficient medical knowledge base with ability to recognize urgent clinical situations and demonstrate communication skills necessary to make appropriate physician referrals to potential patients.
• Assists consumers in scheduling and registering for patient appointments.
• Registers and educate consumers on classes in programs offered by.
• Securely process consumers credit card information accurately with PCI compliance standards upon class registration.
• Educates consumers about additional NMHC services that may meet a patients needs.
• Obtains knowledge about hospital product lines and medical staff to enable cross marketing of services.
• Participate in training programs as new product lines are introduced.
• Maximize opportunities to cross-sell NM services.
• Direct consumers to the NMHC website for additional information as needed.
• Protects the integrity of the proprietary database by entering and updating all consumer/physician demographic information correctly to avoid duplicate or inaccurate records.
• Document codes for all consumer transactions to accurately track call types and effectiveness of all programs.
• Maintain a current and up-to-date knowledge with health care plans to accurately make physician referrals to patients according to their carrier.
• Assist patients on requirements of their particular plans e.g. HMO, IPA and identify alternative resources if needed.
• Other duties as assigned.
• Communication and Collaboration:
  • Keep abreast of all daily correspondence to ensure that consumers are receiving accurate and up to date information.
  • Keep fellow team members informed of all pertinent changes to procedures or any new insights into clinical issues.
  • Interface with various hospital departments and physician offices while directing consumers and physicians through the Northwestern Medicine organization.
• Technology:
  • Utilize Epic and any other appropriate scheduling systems to register patient, schedule appointments, and verify insurance.
  • Respond to Internet requests from consumers.
• Efficiency, Process Improvement, and Business Growth:
  • Maintain the department average for all individual quality goals including contact center metrics, appointment scheduling, database accuracy, and quality monitoring.
  • Focus on continual process improvements for assigned responsibilities to achieve optimal outcomes.
  • Completes telephone contacts to exceed expectations of callers.
  • Monitors queue status closely to minimize wait time of caller.

Qualifications

Required:

• High school diploma or equivalent.
• 2-3 years of Customer Service in Contact/Call Center and/or medical staff office and computer experience.
• Excellent customer service skills.
• Excellent interpersonal, verbal, and written communication skills.
• Proficiency in computer data-entry/typing.
• Excellent verbal and written communication skills.
• Ability to read, write, and communicate effectively in English.
• Basic computer skills.
• Ability to type 40 wpm.
• Ability to multi-task.
• Customer service oriented.
• Excellent organizational, time management, analytical, and problem solving skills.

Preferred:

• Bachelor's degree.
• Additional language skills.
• Healthcare finance and/or healthcare insurance experience.
• Knowledge and experience in a healthcare setting, especially patient scheduling and/or registration.
• Additional training in health care, marketing, or communication.
• Familiarity with health care plans and managed care.

Equal Opportunity

Northwestern Medicine is an affirmative action/equal opportunity employer and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status.