Referral Specialist
Referral Specialist
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USD 21 - 26
1 Vacancy
Job Description
Under the direct supervision of the Health Records and Referrals Manager oversees the Salud wide specialty referral program services at all Salud sites including: meeting educating and followup for referral services. Communicates with patients families staff volunteers and physicians in a manner that focuses on the principles of quality client service. Responsible for the timely process entry and accuracy and followup of referrals in the patients Electronic Health Records.
DUTIES AND RESPONSIBILITIES:
- Follow Medical Provider order as noted and follow through in a timely effective manner.
- Coordinate and process the STAT/URGENT referrals to be completed within 24 hours for patients with critical health care needs.
- Coordinate and process the Routine Referrals in 5 business days.
- Monitor and follow up on EHR referral queue and ensure timely closing of open orders in a 30 60 90 days review system.
- Notify patients of their appointments and location and assist with scheduling interpretation and transportation services; provide followup instructions as needed.
- Verify eligibility by obtaining a RAF TAR or other documentation.
- Ensure complete and accurate registration including patient demographic and current insurance information.
- Assemble information concerning patients clinical background and referral needs. Per referral guidelines provide appropriate clinical information to specialist.
- Maintain ongoing tracking and appropriate documentation on referrals to promote team awareness and ensure patient safety. This tracking may be used in the EHR system by using Task and notes in appropriate fields.
- Contact review organizations and insurance companies to ensure prior approval requirements are met. Present necessary medical information such as history diagnosis and prognosis. Assist with financial information for charity or uninsured programs. Review details and expectations about the referral with patients.
- Respond to patients inquiries in a timely manner in relation to their referrals.
- Train staff as needed on new referral systems.
- Insurance Liaison Verify eligibility pending authorizations and follow up as needed; identifies additional sources of assistance for uninsured and/or underinsured families.
- Organize pediatric and adult referral scheduling and prepare paperwork/records in anticipation of provider needs.
- Liaison between patients providers outside clinics and hospitals regarding scheduling and followup for emergent and shortterm cases.
- Communicate information via computer phone fax and in writing to appropriate resources.
- Reprioritize work on a continuous basis accommodating changes.
- Establish update and maintain a computer based tracking system for all referrals.
- Use computer to enter data or to retrieve information as required. Generate reports as needed.
20. If time allows assist with assignments and cover for other staff members in their absence.
21. Maintain an effective working relationship with staff managers providers and the community.
22. Perform other referrals department duties as assigned.
23. Able to work in a fastpaced environment with individuals of diverse cultural background.
24. Conduct all activities in a polite courteous and professional manner and abides by company policies and procedures.
EMPLOYMENT STANDARDS:
Knowledge of: Must be able to interact and communicate effectively with patients and to maintain a pleasant demeanor when dealing with angry or frustrated callers have excellent communication skills customer service and telephone skills; strong organizational skills and ability to multitask effectively detail oriented and able to work efficiently in a stressful environment a strong sense of teamwork.
Ability to: Understand and carry out oral and written directions respect and maintain patient confidentiality at all times follow policies and procedures work a flexible schedule and work between different locations relate with all levels of individuals within the organization perform daily procedures meeting high quality standards use his/her independent judgment following compliance standards and regulations.
MINIMUM REQUIREMENTS:
- High school graduate
- At least 2 years of general experience in a healthcare environment; OR at least 1 year of general experience in a healthcare environment with 1 year of Referrals processing experience preferred.
- Bilingual English/Spanish required.
- Basic computer knowledge required (MS Word Excel and Outlook) and electronic health records.
Preferred qualifications:
- Completed/Passed Medical Terminology Course.
- Knowledge of ICD10 desired.
- Excellent oral and written communication skills
** Individuals hired on or after March 2018 who have not successfully taken a Medical Terminology class (to be confirmed by proof of taking and passing class with a grade of C or better) will be placed at the Referrals Specialist scale that was in effect prior to March 2018. They will have nine 9 months to successfully complete the class with a grade of C or better and they can use the Education Career Development money to pay for the class.**
PHYSICAL DEMANDS:
- Standing walking sitting typing reaching bending; may move or lift up to 25 pounds.
SALARY & BENEFITS:
Salary:
Benefits: available to all regular Salud employees working 24 hours per week. Parttime employees may receive some benefits on a prorated basis.
- Medical Dental Vision and Life Insurance Plans
- Paid Time Off (PTO): 19 days per year
- Paid Holidays: 12 per year
- 401(k) Retirement Plan with employer contribution
- Voluntary LongTerm Disability
Additional Information:
- Employees on temporary assignments are eligible for holiday pay and California sick pay both prorated based on hours worked.
- Oncall employees are eligible for California sick pay prorated based on hours worked.
Salud is an affirmative action and equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race color religion sex disability age sexual orientation gender identity national origin veteran status or genetic information. Salud is committed to providing access equal opportunity and reasonable accommodation for individuals with disabilities in employment its services programs and activities. To request reasonable accommodation contact the Salud Human Resources Departmentand
Required Experience:
Unclear Seniority
Employment Type
Full Time
