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Referral Specialist
Company : Prime Healthcare Services
Location : Chicago, IL, 60631
Job Type : Full Time
Date Posted : 5 January 2026
Overview
- Department: Neuro
- Schedule: Monday-Friday
- Facility: Prime Healthcare Medical Group
- Location: Saint Francis Hospital: 800 Austin St, Evanston IL
Responsibilities
The following statements are intended to describe the major elements and requirements of the position and should not be taken as an all-inclusive list of responsibilities, duties and skills required of an individual assigned to this job. Acts as a liaison between insurance, healthcare providers, and the clinic to ensure required referrals have been processed correctly for medical specialty visits. The Referral specialist is responsible for scheduling referrals for patients at the request of providers and/or staff. Directly communicates with the clinics, referred to clinics, and patients. Reviews clinical data to report medical necessity to insurance companies. Performs all work with accord to the mission, vision, and values of the practice. The referral specialist makes referrals to specialist for the office practices along with prior auth and creates positive relationships between the office practices and specialists. Other duties include, but are not limited to, filing/scanning patient reports, retrieving patient records for prior authorizations or medical records and completes insurance prior authorization. The Referral specialist should demonstrate adequate knowledge of the usual terminology of Referral process and tests/surgeries along with insurance plans. This person should demonstrate good telephone etiquette and be able to speak to patients and others in a polite and friendly manner. Be able to maneuvers through prior authorization with insurance companies and provide patient support by utilizing resources such as sliding fee scale, payment arrangements etc. Conveys a positive image of the organization and maintains a upbeat customer friendly attitude for internal and external Customers.
Qualifications
EDUCATION, EXPERIENCE, TRAINING
1. 2 year experience in a clinic work environment preferred.
2. Knowledge of medical terminology preferred.
3. Completion of medical assistant program desired Certified within 6 months of hire.
4. Knowledge of Electronic Medical Systems.
5. Excellent phone skills and customer service skills.
6. Upbeat, positive, customer friendly attitude towards internal and external customers.
7. Knowledge of prior authorizations and insurance plans.
8. Good organization skills.
9. Be able to act as a patient liaison to help them through navigate the healthcare system.
10. Be a self-starter and able to multi-task.
11. Able to organize and trouble shoot scheduling and or referral issues and have solutions.
12. Detailed orientated.
13. Be able to work in a changing environment.
Pay Transparency
Prime Healthcare Illinois Medical Group offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $16.86 to $24.42. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.
The company is dedicated to empowering its staff with a comprehensive, competitive benefits package, allowing them the freedom to customize their benefits to fit their unique needs. Our abundant resources, programs, and voluntary options serve as a foundation for individual growth and well-being. Learn more here: https://www.primehealthcare.com/benefitsthatmattermost/
Employment Status
Full TimeShift
DaysEqual Employment Opportunity
Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf
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Frequently asked questions
In Chicago, Referral Specialists must skillfully handle prior authorizations by liaising with insurance providers and clinics to ensure medical necessity is approved swiftly. Familiarity with local insurance plans and clear communication boosts appointment scheduling accuracy and patient satisfaction.
Working in Prime Healthcare's neuro department involves coordinating specialized care referrals, managing sensitive clinical data, and ensuring compliance with insurance protocols. Specialists need in-depth medical terminology knowledge and excellent multitasking abilities to support both patients and providers effectively.
Prospective Referral Specialists should focus on building medical terminology expertise and customer service skills. Completing a medical assistant program and gaining familiarity with electronic medical records can bridge experience gaps, enabling smoother adaptation to referral coordination roles.
Referral Specialists uniquely coordinate with providers, insurance companies, and patients to process referrals and prior authorizations. Unlike broader patient service roles, they emphasize scheduling specialty visits and managing insurance documentation, requiring detailed organization and clinical data review.
Chicago's healthcare sector shows steady demand for Referral Specialists, especially within hospital networks like Prime Healthcare. Competition is moderate, favoring candidates proficient in insurance navigation, electronic medical systems, and customer relations, which enhances hiring prospects locally.
While Prime Healthcare primarily offers on-site Referral Specialist positions, the evolving healthcare environment may introduce remote referral coordination roles. Applicants interested in remote work should monitor company updates and consider roles emphasizing telehealth support or virtual patient liaison tasks.
Prime Healthcare invests in employee growth through tuition reimbursement and access to various voluntary benefits. Referral Specialists benefit from training resources that enhance medical knowledge and administrative skills, fostering upward mobility within healthcare administration.
Referral Specialists at Prime Healthcare in Chicago can anticipate compensation between $16.86 and $24.42 per hour. This range reflects experience, certifications, and skill set, alongside comprehensive benefits like medical coverage and retirement plans tailored to employee needs.
Certifications such as Medical Assistant credentials or specialized training in medical billing and prior authorizations are highly regarded in Chicago. These credentials enhance a candidate's ability to manage referral workflows and insurance procedures efficiently within local healthcare systems.
At Prime Healthcare, Referral Specialists engage closely with neuro departments and benefit from a structured Monday-Friday schedule. The role emphasizes building positive relationships between office practices and specialists, supported by a culture valuing upbeat customer service and comprehensive benefits.