Job Summary:

The Patient Referral Coordinator manages the referral process for patients who require specialized care beyond the scope of their primary care physician. Primary responsibilities include ensuring that referrals are processed promptly and efficiently, requesting appointments with specialists, and effectively communicating with patients and healthcare providers about the referral process and progress. The Patient Referral Coordinator adheres to the principles of service and the philosophy and mission of Del Puerto Health Center in all aspects of job performance. The Patient Referral Coordinator assists and supports the Health Center Supervisor and the Health Center Manager in accordance with current policies and procedures, guidelines, regulations, and applicable federal, state, and local standards.

Essential Duties and Responsibilities:

To perform this job successfully, an individual must satisfactorily perform each essential duty. The requirements below represent knowledge, skill, and/or ability. Reasonable accommodation may be made to enable individuals with disabilities to perform essential duties. Other duties may be assigned

Referrals and Authorizations

· Ensure timely processing and submission of physician referrals for specialists, durable medical equipment (DME), and medication.

· Adhere to Referral Tracking Policy and Procedures to obtain patient referrals and authorization.

· Accurately document patients' referral progress and approval information in the Electronic Health Record (EHR). Document all actions to ensure staff and providers are aware of referral progress.

· Ensure the specialist's office is in-network with the patient's insurance.

· Verify patient eligibility with insurance carriers through effective communication.

· Update and scan patient medical records to maintain accurate records.

· Securely submit patients' medical records to support authorization requests.

· Obtain pre-authorization, if required, for the patient's treatment.

· Schedule patient appointments with healthcare providers as necessary.

· Conduct meticulous follow-ups on all referrals to ensure efficient processing and timely completion.

· Promptly follow up with patients and office referrals/authorizations to ensure continuity of care.

· Answer and respond to phone calls/voicemails in a timely manner and document them in EHR.

· Maintain updated referral/pre-authorization forms for proper submission to specialist and/or insurance carrier.

· Cultivate positive and professional relationships with insurance carriers and physician offices.

· Communicate professionally with patients to provide updates on referral progress and appointment scheduling.

· Perform other duties as assigned by the Health Center Supervisor and/or Health Center Management.

In order to excel in this role, the incumbent must perform our principles of service to a satisfactory standard. The requirements below represent the required knowledge, skills, and abilities.

· Maintain a professional demeanor in all interactions with patients, family members, providers, office staff, members of the community, and external agencies.

· Handle confidential and protected health information (PHI) appropriately, understanding the importance of confidentiality and non-disclosure in accordance with HIPAA guidelines.

· Demonstrate proficiency using Microsoft Office 365 and electronic medical/health records.

· Demonstrate cultural sensitivity and work effectively with ethnically diverse populations.

· Attend general and medical staff meetings as required.

· Keep the office area assigned to you clean and organized.

· Request office supplies when needed for your area.

Supervisory Responsibilities: None

Qualification Requirements:

To perform this job successfully, an individual must perform satisfactorily in each essential duty. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform essential functions.

· Excellent verbal and written communication skills

· Excellent time management skills with a proven ability to meet deadlines.

· Excellent interpersonal and customer service skills.

· Excellent organizational skills.

· Outstanding abilities with Microsoft Office Suite.

Experience

· Minimum 1-year medical front office experience, preferred

Language, Education, And Licensing

· High School Diploma or GED

· Certified Medical Assistant (Preferred)

· Current CPR Card or ability to become certified within 60 days

· Bilingual English/Spanish, preferred

Other Skills And Abilities

· Ability to act with integrity, professionalism, and confidentiality.

· Ability to communicate with co-workers and the public professionally and effectively.

· Ability to handle confidential information.

· Ability to follow HIPAA non-disclosure standards.

· Ability to work with ethnically diverse people in a culturally sensitive manner.

· Knowledge of medical terminology and common medical office clerical procedures, including computerized billing and accounts payable systems.

· Ability to pay attention to details.

· Ability to function well in a high-paced environment and to wait patiently.

· Ability to define problems, collect data, establish facts, and draw valid conclusions.

· Flexibility and willingness to work on an as-needed basis to meet the health center's operational needs.

Physical Demands:

The physical demands described here represent those that an employee must meet to perform the essential functions of this job successfully. Reasonable accommodation may be made to enable individuals with disabilities to perform these functions.

While performing the duties of this job, the employee is frequently required to sit, use hands to finger, handle or feel objects, tools, or controls, reach with hands and arms, and talk or hear. The employee is occasionally required to stand, walk, climb, balance, stoop, or crouch.

The employee may occasionally lift and/or move up to 50 pounds and push up to 100 pounds on wheels. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. (See the complete “Physical Requirements” attached.)

Work Environment:

The business office work environment characteristics described here represent those encountered while performing the essential functions of this job.

Risk Exposure Category 1:

Risk of exposure to blood/body fluids, based on Health Clinic location.

DISCLAIMER:

This job description indicates the critical features as described under the headings above. They may be subject to change at any time due to reasonable accommodation or other reasons. The incumbent may be asked to perform other duties as assigned.

ADDITIONAL INFORMATION

· All your information will be kept confidential according to EEO guidelines.

· Del Puerto Health Care District is an Equal Opportunity Employer. Minorities, women, veterans, and individuals with disabilities are encouraged to apply.

· Del Puerto Health Care District participates in E-Verify during the hiring process for all new employees.

Pay: $23.42 - $28.80 per hour

Benefits:

403(b)
Dental insurance
Disability insurance
Health insurance
Life insurance
Paid time off
Vision insurance

People with a criminal record are encouraged to apply

Work Location: In person

Del Puerto Health Care District/ Del Puerto Health Center jobs

Referral Coordinator