Referral Coordinator

Position Summary:

The Referral Coordinator (REFC)reports to the Referrals Manager and provides clerical and administrative support to the health center for the organization of internal and external referrals. This position will support the daily needs of all of the Referral Coordination for the medical department in the health center. The REFC is responsible for ensuring that all appointments, required documentation, insurance information and prior authorizations are established with specialty providers, insurance entities and patients.

Essential Functions:

• Receives referral requests from providers and communicates with them, or a member of the patient’s care team, as needed
• Obtains prior authorizations for patient referrals to specialists and surgeries. Advises provider if authorization request is denied.
• Communicates with different insurance companies to process referrals appropriately and verifies eligibility of insurance for patients
• Requests appointments from appropriate specialty providers
• Verifies eligibility of insurance for patients
• Communicates with patients and informs them of referral status
• Requests consult notes once patient has been seen by specialist and closes referrals upon receipt.
• Communicates with Specialist regarding referral needs.
• Follows up on referrals with specialty providers and patients.
• Obtains ongoing knowledge, documentation, and updates of appropriate referral resources, required forms and key contact persons
• Reviews and assesses medical records for referral processing.
• Tracks and processes referral using NextGen Diagnostics and Referrals sections in the A/P section of the SOAP note.
• Prioritizes and processes referrals by urgency or PCP request.
• Completes referral data tracking for Quality Assurance programs.
• Complies with all state and federal laws and regulations, as they pertain to position including; HIPAA, sexual harassment, Scope of Practice, OSHA etc.
• Other duties as assigned.

Skills and Abilities:

• Excellent computer skills, preferably with Windows, including Microsoft Office Suite
• Excellent telephone and communication skills
• Must possess excellent organizational, writing, and verbal skills.
• Ability to work independently, set priorities, and work well under pressure.
• Ability to maintain a high degree of confidentiality

Competencies:

• Attention to Detail
• Customer Service
• Insurance Verification
• Record Maintenance
• Research

Minimum Qualifications:

• High School diploma or equivalent.
• Minimum of 1 year of experience in office setting
• Excellent computer and technology skills.
• Ability to communicate orally and in writing; professional demeanor and the ability to represent SNAHC in the community.

Preferred Qualifications:

• Experience with NextGen EHR/PM software.
• Knowledge of Medi-Cal, Medicare, and managed care plans
• Knowledge of medical terminology and medical procedure terminology

Benefits:

• Supportive and creative work environment.
• Medical coverage offered with two of the region's highest quality providers.
• 403B plan with a 3% match after 90 days.
• 12 paid days off.
• Paid Time Off
• Flexible Spending Account

Preference in hiring is given to qualified Native Americans in accordance with SNAHC policy. Applicants claiming Indian Preference are encouraged to submit verification of Indian certified by tribe of affiliation or other acceptable documentation of Indian heritage.

EQUAL OPPORTUNITY EMPLOYER: Within the scope of Indian Preference, all candidates will receive equal consideration without regard to race, color, age, gender, religion, sexual orientation, national origin, medical condition or physical or mental disability, genetic characteristic, pregnancy, marital status, veteran status, or other non-merit factors.

Age Discrimination in Employment Act (ADEA): Sacramento Native American Health Center, Inc. abides by the mandates of the ADEA (protecting individuals 40 years and older) and considers age a non- merit factor in all employment decisions and considerations.

Americans with Disabilities Act(ADA): Sacramento Native American Health Center, Inc. abides by the mandates of the ADA and considers disability a non-merit factor in all employment decisions and considerations. Furthermore, SNAHC will make any practical, feasible, and reasonable arrangements to accommodate qualified applicants and employees with disabilities.

Applicants and employees may request an accommodation of a physical or mental disability at any time in the application process or during employment

Note to Applicants: Please be advised that you may be asked to get a Department of Justice Fingerprinting clearance as a contingency for an offer of employment. Criminal clearances are obtained to protect the welfare and safety of clients receiving services at SNAHC.

As a condition of employment, all Sacramento Native American Health Center employees agree to a Covid-19 vaccination except where otherwise prohibited or where other legal exemption by law is allowed.

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Education

• High School or better

Skills

• Back Office Experience
• Communication Skills
• Maintain high degree of confidentiality
• Ability to work independently
• Ability to work under pressure
• Ability to set priorities
• Superior professionalism dealing with all