Referrals Assistant - Lakeport, United States - LAKE COUNTY TRIBAL HEALTH CONSORTIU

LAKE COUNTY TRIBAL HEALTH CONSORTIU

Verified Company

Lakeport, United States

3 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

TITLE:

REFERRALS ASSISTANT

DEPARTMENT:

FISCAL

SUPERVISED BY:

PRC MANAGER

CLASSIFICATION:
FULL-TIME / NON-EXEMPT

***: Functions as a member of the Medical Department Patient Care Team with close interdepartmental ties to PRC. Provides Assists the Referral Coordinator with processing medical/dental/behavioral health referrals for patients and contributes as an integral part of the CQI activities for PRC.PRC department.

ESSENTIAL JOB FUNCTIONS:

Gathers information/medical records for referral M.D.s and mails or faxes the information.
Schedules transport for patient if needed for the referral appointment.
Schedules referral appointments as needed.
Maintains a Vendor/Provider book file with information including: vendors/providers, specialty, location, and different insurances accepted by them.
Obtains insurance pre-approvals on procedures, RAFs and Treatment Authorization Requests from Medi-Cal, CMSP and private insurance
Sends confirmation notices for referral appointments.
Enters medical referrals on RCIS referrals program
Maintains follow-up logs for referrals and consultations.
Obtains PRC authorization or denial on every referral and gives a copy of authorized referral to PRC personnel.
Collaborates with Administration (PRC) to effect ongoing improvements in services.

Negotiates discounts with hospitals, clinics, physicians, dentists and others for PRC Referrals in accordance with established regulations.
Monitors and prepares referrals according to high cost and submits to PRC Committee for review. Seeks lowest cost on referred services when they are to be paid out of PRC.

Performs related tasks as directed.
Create monthly reports to present at the PRC monthly meetings with the Board of Directors

EDUCATION, EXPERIENCE, CERTIFICATIONS AND LICENSES:

High School graduate or GED. Relevant college courses preferred.
Certified Nurses Assistant CertifiateCertificate preferred
Ability to keep accurate records and ability to organize multiple tasks.
Prior experience in an office practice or medical clinic.
Ability to operate basic office equipment (i.e., fax machine, computer, copier, etc.).

CPR certification.

Excellent telephone/verbal communication and patient skills.
Ability to analyze and interpret governmental regulations.
Ability to define problems, collect data, establish facts and draw valid conclusions.
Work independently, be organized, flexible and prioritize responsibilities maintaining a calm productive atmosphere.
Ability to interact professionally with patients and providers.
Ability to interpret data about patients status in order to identify each patients age specific needs and requirements.
Cooperate with other personnel to achieve departmental objectives and maintain good employee relations.
Valid California Drivers License with satisfactory driving record.

All LCTHC employees are expected to:

Provide the highest possible level of service to clients;
Promote teamwork and cooperative effort among employees;
Maintain safe practices; and
Abide by the LCTHC policies and procedures as they may from time to time be updated.

PHYSICAL DEMANDS:

The physical demands described here are representative of those that must be met by an

INDIAN PREFERENCE:

Preference may be given to qualified Native American Indians according to the Indian Preference Hiring Act, CFR 25 USC 472.

Other than Indian Preference, Lake County Tribal Health Consortium, Inc. adheres to all provisions of the Equal Employment Opportunities Act.

NOTICE OF DRUG-FREE WORKPLACE ACT REQUIREMENT: LCTHC is committed to maintaining a drug free and alcohol free workplace. LCTHC believes that a healthy, productive workforce free from the effects of drugs is very important to all employees and patients. Substance abuse is incompatible with the health, safety, efficiency and the success of LCTHC.

Employees who are under the influence compromise LCTHC?S interests, endanger their own and the health and safety of others and can cause a number of other work-related problems.

As a condition of employment, each applicant receiving a job offer from LCTHC must take and pass a required drug screen test.

HIPAA Health Insurance Portability and Accountability:
This act was enacted to deal with three main areas with regard to patient information.

Security of health information
Standards of electronic transactions
Privacy of individually identifiable health information

IMPORTANT DISCLAIMER NOTICE

The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive of the tasks that an employee may be required to perform.

The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerati