Referrals Coordinator

Referrals Coordinator

Website SAC Health System

ESSENTIAL FUNCTIONS AND DELIVERABLES:

  • Processes incoming referral requests daily.
  • Reviews referral orders for accuracy of codes and supporting documentation.
  • Receives, processes and verifies accuracy of authorizations.
  • Receives and processes specialty notes to primary care physician to facilitate on-going authorizations for continued care.
  • Serves as liaison and authorization resource to clinic staff, outside medical groups and patients.
  • Knowledgeable and familiar with insurance policies, referral, and authorization processes. Works with insurance companies / managed care groups to ensure pre-visit information is sent to patients as needed.
  • Utilizes exceptional customer service skills in performing duties and assists with problematic referral and authorization process. Ability to resolve problems in a timely manner.
  • Recommends improvements to department processes as appropriate.
  • Contacts insurance company(s) to verify patient eligibility and benefits.
  • Contacts patients as needed to update demographics. Informs patients/guarantors of their financial responsibility for scheduled services.
  • Informs patients and/or clinic the staff of any insurance problems affecting future services.
  • Develops and maintains professional working relationships with outside providers, vendors and insurance groups involved in the referral process. Ability to work cohesively with all other SACHS departments.
  • Maintains an accurate and up-to-date tracking system for referrals and authorizations.
  • Maintains current referral forms and insurance resource materials.
  • Monitors and reports productivity statistics data to supervisor on a weekly basis.
  • Performs general clerical duties including, but not limited to, typing, filing, answering the telephone, monitoring incoming faxes/mail and assisting patients/providers at a service window or patient exam room.
  • Performs other duties as assigned.
  • Assists supervisor with special projects, as requested
  • Must be able to adhere to the Attendance policy and procedure.
  • Ability to collaborate, teach, support and function in a teaching organization that builds, coaches and embraces interns and residency programs. Must demonstrate a passion for the team and have the ability to consistently work with rotating doctors, residents and interns, while continuously building a trusting, safe, patient-centered workplace.
  • Demonstrate the ability to be culturally sensitive and respect diversity, work effectively and with individuals of different cultures and socioeconomic status; Passion for service.

Education and Experience:

  • High school diploma or equivalent
  • 3-5 years of customer service, or Referral experience in the medical field
  • Medical terminology required
  • As a requirement of this position, you must receive EPIC certification for the module you have been hired into.

Preferred:

  • FQHC outpatient clinic
  • Bilingual English/Spanish
  • Drop files here or