- 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 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.
- 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.
- Perform other duties as assigned by the Manager.
- Education: High School Diploma or equivalent required.
- Licensure/Certification: N/A
- Experience: Minimum of two year's referral experience required within 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.
- Essential Technical/Motor Skills: Must have proficient computer skills including data entry (35wpm). Must be able to use a variety of office equipment including fax machine, scanner, printer and copier.
- Interpersonal Skills: Must have professional telephone etiquette combined with a pleasant and courteous voice. Strong public relations skills are essential. Fluency in English and Spanish required. The ability to translate medical information is preferred. Must possess the ability to maintain a professional attitude in difficult situations and communicate effectively. Must perform as a team player.
- PTO and Sick Leave Plans
- Medical / Dental / Vision package
- Monthly Health Insurance Premium Rates among the lowest in the industry
- Retirement Account with up to 8% employer contribution
- Employer-paid Life Insurance
- Fitness Facility access
- 9 Paid Holidays
- 1 Paid Birthday Holiday
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Referral Coordinator - San Bernardino, United States - SAC Health
Description
Job Description
Job DescriptionAbout SAC Health:
SAC Health's mission is to reflect the healing ministry & love of Jesus Christ through healthcare, education & partnerships that empower our communities to flourish.
SAC Health's Core Values:
Quality Healthcare - providing patient-centered, culturally-sensitive, equitable care that is safe, timely, effective, efficient, while seeking to prevent illness & disability
Teamwork - working together to achieve a common goal, with a willingness to serve each other in a Christ-like manner
Wholeness - ministering to the spiritual, physical, mental & emotional needs of others
Integrity - living & working in an authentic, honest way that inspires trust
Compassion - engaging with the needs & suffering of others, out of concern for their well-being
Excellence - striving to exceed expectations for our patients, community, & staff
Humble Service - caring with a kind & selfless spirit
Respect - holding others in high regard by empowering them to reach their God-given potential
DESCRIPTION:
The Referral Coordinator understands referral/authorization process for multiple payer sources. Offers guidance to providers on the ordering of referrals as needed. Processes and ensures completion of referral orders to specialists. Works under the supervision of the Referrals Supervisor to ensure accurate and timely review and processing of authorizations. Requires exceptional accuracy, organization, communication and office and interpersonal skills. Performs other duties as needed.
Schedule: 4 days per week, 10 hours per day
ESSENTIAL FUNCTIONS AND DELIVERABLES:
QUALIFICATIONS:
Must be legally authorized to work in the United States on a full-time basis. Must not now or in the future require sponsorship for employment visas.
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Full Benefits Package:
EEO
SAC Health complies with applicable Federal and State civil rights laws and does not discriminate based on race, color, national origin, age, disability, sex, sexual orientation or gender identity.
