Referral Support Specialist (Hybrid)

Join the Erie team! Motivated by the belief that healthcare is a human right, we provide high quality affordable care to support healthier people, families, and communities. Erie delivers holistic care to help every member of the family stay healthy and active from infancy through adulthood. Since 1957, we have provided high-quality care to diverse patients most in need, regardless of their insurance status, immigration status, or ability to pay.

Erie Family Health Centers, a nationally recognized top workplace with 14 sites in Chicago and suburbs, is looking for a valuable addition to our Operations Team! The Referral Support Specialist (RSS) performs primary duties associated with referring patients to internal and external health care resources. The RSS directly works with patients, hospitals and providers regarding referral processes and appointment requests, while also exhibiting quality customer service.

At Erie, we are proud to provide competitive salaries, high-quality health care plans, generous time off benefits, retirement benefits, and more! Erie employees are eligible for Erie's Full Benefits Package that includes Medical, Dental, Vision, Life and Disability Insurance and Flexible Spending (FSA) for Health Care or Childcare. Retirement Programs: 401(k) program with Erie matching $0.50 for every $1.00 up to the first 5% of the employee's biweekly salary. Annual Paid Time Off: starting at 15 days of PTO, and 8 paid holidays. Competitive salary, annual merit increases, plus room for growth and career advancement.

• Compensation is based on each candidate's experience, skills and education within the range identified for the role. Candidates who meet the minimum requirements of the role will start at entry in the range. Any additional skills, experience and education will be reflected in the compensation offered.

Main Duties & Responsibilities

• Process and manage referrals using EMR, including insurance verification, financial eligibility review, prior authorizations, and referral submission through insurance portals, fax, and electronic workflows.
• Ensure referral accuracy and completeness by validating diagnoses, supporting documentation, and medical necessity; coordinate with providers, patients, hospitals, and insurance companies to resolve issues and denials.
• Track, maintain, and follow up on referral statuses, work queues, and Transition of Care (TOC) referrals to ensure timely processing and closure.
• Respond to patient, hospital, and insurance inquiries related to referrals through phone, MyChart, Artera, and other communication channels.
• Support electronic referral processes, workflow improvements, referral tool updates, staff training, escalations, meetings, and other departmental initiatives as assigned.

Education:

• High School Diploma or equivalent required.

Experience:

• At least six (6) months of Referral Support Specialist I or one (1) year in administrative healthcare required
• Experience with referrals prior authorizations a plus

Skills and Knowledge

• Basic computer skills required.
• Intermediate EPIC skills required.
• Intermediate proficiency in Microsoft Office required.
• Ability to work independently and within a team required.
• Cultural competency to work with a diverse patient population is required.
• Bilingual fluency (English/Spanish) is a plus.

THE ERIE ADVANTAGE PLEDGE:

Working Together for What Matters Most

Erie makes a pledge that all current and future employees can feel confident that:

• Our mission, vision, and values unite us.
• Our voices matter.
• We do things well.
• Our inclusive culture promotes balance and belonging.
• We find our career sweet spot at Erie.