Referral Coordinator

The Sacramento Native American Health Center Inc. (SNAHC) is a non-profit 501 (c)(3) (Federal Tax ID # 20-4287737) Federally Qualified Health Center, with multiple locations in Sacramento, CA. The health center is committed to meeting patients where they are and supporting their health goals through the provision of culturally competent, holistic, and patient-centered continuum of care.

At SNAHC, you are joining a team and organization at a time of growth and transformation. You will love being surrounded by people who are as passionate as you are about community health. Individual compensation for this position will be determined at the organization’s discretion and the wage range for this role considers multiple factors including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. It is not typical for an individual to be hired at or near the top of the salary range and compensation decisions are determined thoughtfully in each case. A reasonable estimate of the current range is $17.74 to $24.00 per hour.

Position Summary:

The Referral Coordinator (REFC) reports to the Referral Supervisor 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.
• Actively participates in internal quality improvement teams. Works with members proactively to support quality improvement initiatives in accordance with the mission and strategic goals of the organization, federal and state laws and regulations, and accreditation standards.
• 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

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