Job description

Retina Consultants, Ltd. is a medical and surgical retina practice serving the greater Chicago area with offices in Des Plaines, Libertyville, Elgin, Lisle, and Hickory Hills. The team specializes in adult retinal disease and pediatric retinal disease and has been providing unmatched care to the Chicago area for over 35 years.

We are dedicated to giving our patients the highest level of care and compassion as we navigate them through the often-frustrating world of insurance, referrals, and prior authorizations. The referral manager is a vital member of the Retina Consultants team and works in conjunction with the clinical, billing, and front desk team to verify insurances and obtain authorizations for procedures.

RESPONSIBILITIES

• Confirm and validate patient insurance coverage by contacting insurance companies via phone, online portals, or other designated methods.
• Gather and document accurate patient information, including demographic details and insurance policy specifics.
• Communicate with patients to explain their insurance coverage, benefits, and any potential out-of-pocket expenses associated with medical services.
• Collaborate with healthcare providers to obtain and update necessary information related to patient insurance.
• Initiate pre-authorizations for procedures and request office visit referrals.
• Identify and address discrepancies or issues with insurance information, working proactively to resolve any challenges that may arise.
• Record and maintain accurate insurance details in electronic health records (eClinicalworks and epic) and billing systems.
• Adhere to all relevant healthcare regulations and guidelines, including HIPAA, in handling patient information.
• Establish and maintain positive relationships with insurance company representatives, addressing inquiries and obtaining necessary information.
• Develop and implement efficient workflows and procedures to streamline the referral process and improve productivity.
• Train and supervise referral staff, providing guidance and support to ensure adherence to best practices and quality standards.
• Demonstrate proactive, professional communication across and within department to facilitate smooth workflow, and to ensure department is positively represented throughout the organization

QUALIFICATIONS

• High school or equivalent (Required)
• Prior experience in insurance verification and medical office (Required)
• Working knowledge of insurances, referrals, and prior authorizations (Required)
• Must be excellent at multitasking
• Strong communicator with ability to problem solve and take initiative
• Must be very detail oriented and organized
• Ability to focus and work quickly

Job Type: Full-time

Pay: $50,000.00 - $55,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Weekly day range:

• Monday to Friday

Experience:

• Insurance verification: 1 year (Preferred)
• Medical billing: 1 year (Preferred)

Ability to Commute:

• Des Plaines, IL 60016 (Required)

Ability to Relocate:

• Des Plaines, IL 60016: Relocate before starting work (Required)

Work Location: In person