Lead Referrals Coordinator

Who We Are:

SAC Health empowers our patients and their families to live vibrant and healthy lives through culturally responsive exceptional care. Patient-centered whole-person care. Our unique full scope team-based approach is what makes SAC Health the provider of choice for patients.

Top-Tier Patient Satisfaction Scores Largest Teaching Health Center FQHC 11 Locations offering 44 Specialties NCQA Patient-Centered Medical Home Level 3 Certified Multi-Site Approved for NHSC & NCLRP loan forgiveness programs - NHSC/Nurse Corps/Pediatric Specialty HPSA Scores: Primary: 17 Dental: 25 Mental: 20

What We Are Looking For

Under the direction of the Supervisor Referral Coordinator the Lead Referral Coordinator is responsible for the coordination processing and scheduling of specialty referrals and prior authorizations for a variety of medical services/procedures for patients as requested by the primary care physician. As an integral member of the patients health home the Referral Care Coordinator Lead will collaborate with medical providers nursing staff and other patient care support staff to ensure patients receive specialty services timely and efficiently in alignment with department of health care guidelines. The Lead Referral Coordinator will also be responsible for providing training on standard work procedures. Additionally this role acts as a liaison with staff departments clinics and patients.

Schedule: 4 days per week 10 hours per day Monday - Thursday 7:00 am - 5:30 pm Location: Brier Clinic San Bernardino CA

ESSENTIAL FUNCTIONS AND DELIVERABLES

• Assist Referral Coordinators with achieving team and individual goals guide team members ensure tasks are completed and provide technical expertise.
• Assist with referrals and resolve patient issues.
• Ensure referrals and authorizations are processed appropriately and on time.
• Maintain knowledge of insurance policies referral and authorization procedures.
• Work with insurance companies / managed care groups to ensure pre-visit information is sent to patients as needed.
• Maintain an accurate and up-to-date tracking system for referrals and authorizations.
• Utilize exceptional customer service skills in performing duties and assists with problematic authorization processes.
• Contact patients as needed to update demographics and informs them or /guarantors of their financial responsibility for scheduled services.
• Review referral orders for accuracy of codes and supporting documentation.
• Receive and process specialty notes to primary care physicians to facilitate ongoing authorizations for continued care.
• Recommend improvements to department processes as appropriate.
• Understand the referral process at the highest level and assist referral staff to ensure compliance with program guidelines.
• Assist referral staff to ensure accurate and timely review and entry of authorizations from referring entity.
• Assist with difficult patient situations and processes.
• In coordination with the Referrals Supervisor plan organize direct coordinate and supervise the operations of the referrals department.
• Monitor and report productivity statistics data to the supervisor on a weekly basis; may assist in monitoring other coordinators statistics.
• Assist the supervisor with special projects as requested.
• Serve as a liaison and authorization resource to clinic staff outside medical groups and patients.
• Perform general clerical duties including typing filing answering the telephone monitoring incoming faxes/mail and assisting patients/providers at the service window or patient exam room.
• Develop and maintain professional working relationships with outside providers vendors and insurance groups involved in the referral process.
• Work cohesively with all other SAC Health departments.
• Demonstrate a caring and compassionate commitment to patients and their unique circumstances.
• Lead by example and ensure all employees promote the mission by displaying behavior consistent with SAC Core Values.
• Demonstrate flexibility adaptability; and the ability to work under pressure to meet deadlines.
• Work as a team and contribute to development of an effective work environment.
• Transforms delivery of clinical care - Promote services and program strategies that provide an exceptional patient - centered experience by developing a seamless care delivery system and innovative care models to improve quality outcomes reduce unnecessary clinical variation and improve coordination across the continuum.
• Perform other duties as assigned by department leadership.

QUALIFICATIONS:

• Education: High School Diploma or equivalent required. Associates degree preferred.
• Licensure/Certification: As a requirement of this position you must receive EPIC certification for the module you have been hired into.
• Experience: Minimum of one (1) year experience in medical referrals or other related medical patient support functions in an ambulatory care setting preferred. Intermediate proficiency in data analysis. Proficient in Microsoft Office and electronic medical record system (EMR). Knowledge of referral operations (in order to interpret and validate data findings) preferred.
• Essential Technical/Motor Skills: Must have proficient computer skills including data entry (35wpm). Computer proficiency: Excel Word Outlook EPIC PDF etc.
• Interpersonal Skills: Ability to work effectively in a team environment is essential. Must have professional telephone etiquette with a pleasant and courteous voice. Strong public relations skills and fluency in English and Spanish are required. Ability to translate medical information is preferred. Must maintain a professional attitude in difficult situations communicate effectively and work well in a team. Strong organizational skills attention to detail and excellent communication and interpersonal abilities are essential.
• Essential Mental Abilities: Requires strong critical thinking and decision-making skills. Flexibility and the ability to handle various tasks and changing priorities are essential. The candidate must be well-organized able to manage multiple tasks efficiently and handle multiple phone lines simultaneously.
• Work Eligibility: 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.

EEO: SAC Health is committed to fostering a diverse equitable and inclusive work environment and is committed to being an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race color religion gender gender identity or expression sexual orientation national origin genetics disability age or veteran status.

Full Benefits Package Effective on Your First Day!

Industry Leading PTO Accrual (accrued per pay period) Sick Leave Paid Holidays Paid Jury Duty Bereavement SAC Health Covers approximately 85% of Team Member health premium costs (may vary w/benefit plan selection) Retirement - up to 8% employer contribution Continuing Education and Learning Benefits Annual Mission Trip and much more!

Learn More About the Work We Do:

SAC Healths Mission: SAC Healths mission is to reflect the healing ministry & love of Jesus Christ through healthcare education & partnerships that empower our communities to flourish.

SAC Healths Core Values: Quality Healthcare - Teamwork - Wholeness -Integrity - Compassion - Excellence - Humble Service - Respect