AIM's Operations Group is seeking client-focused individuals to join the contact centers precertification team as a Health Care Customer Service Specialists (Referral Specialists).
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Hiring Company: AIM Specialty Health
At AIM Specialty Health ® (AIM), it's our mission to promote appropriate, safe, and affordable health care. As the leading specialty benefits management partner for today's health care organizations, we help improve the quality of care and reduce costs for today's most complex tests and treatments.
AIM provides clinical solutions that drive appropriate, safe and affordable care. Serving more than 50 million members across 50 states, D.C., and US territories, AIM promotes optimal care through use of evidence-based clinical guidelines and real-time decision support for both providers and their patients. Our platform, featuring a sophisticated clinical rules engine from Applied Pathways (a wholly owned subsidiary of AIM), delivers significant cost of care savings across an expanding set of clinical domains, including radiology, cardiology, oncology, specialty drugs, sleep medicine, musculoskeletal care, and genetic testing.
Job Description: Referral Specialist
AIM's Operations Group is seeking client-focused individuals to join the contact centers pre-certification team as a Health Care Customer Service Specialists (Referral Specialists).
- Enter demographic and screening information from a requesting physician office or provider via telephone or web-based input into the preauthorization computer system
- Screen preauthorization requests using approved criteria and guidelines
- Identify and appropriately refer cases to preauthorization nurses for clinical review
- Provide information to referring/rendering physician offices and network service providers regarding program requirements
- Maintain personal client files updated with the most current client fact sheets provided
- Monitor department voice mail and process preauthorization requests in accordance with departmental guidelines
- Maintain telephone service standards in accordance with departmental goals
The qualified candidate will have:
- H.S. diploma or GED
- 2 years in a high-volume, fast-paced interactive customer service or call center environment; or equivalent combination of education and experience
- Working knowledge of medical terminology preferred
- Detailed oral and written communications skills required
- Candidates should have solid typing speed and accuracy, and good computer skills, with the ability to utilize multiple computer systems in desktop environment to accomplish results
Compensation & Benefits
- $17 per hour
- Benefits include:
- An array of Health, Dental and Vision Care Insurance plans
- Term Life Insurance
- Short- and Long-term Disability Insurance
- 401(k) Employee Savings Plan with company match
- Paid Time Off
- Tuition Reimbursement
- Tax-advantaged health care and dependent flexible spending plans
- Health club reimbursement allowance
- Licensure reimbursement for medical professionals
2 Westbrook Corporate Center
Westchester, IL 60154
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