Referral Associate, Outpatient - RHC Referral Center (Full-Time, Day Shift)
About The Position
Lying just inland between the State's coastal mountain ranges and the Sierra Nevada Mountains, Adventist Health Reedley has been serving the Central Valley since 2011. We are comprised of a 49-bed acute care hospital and 60 clinics in 27 rural communities with primary and specialty care services. Reedley is a perfect location for outdoor enthusiasts as it is located in the central San Joaquin Valley portion of California, close to Yosemite, Sequoia and Kings Canyon National Parks. In addition to the beautiful landscape, it also offers a great cost of living and close-knit communities. Job Summary: Coordinates and completes referrals within the Hospital-based Outpatient Clinics (HBOC) including acquiring and verifying third party information, obtaining and arranging appointments and tracking. Works on routine assignments within defined parameters, established guidelines and precedents. Follows established procedures and receives daily instructions on work.
Requirements
- High School Education/GED or equivalent
Nice To Haves
- Associate’s/Technical Degree or equivalent combination of education/related experience
- Certified Nurse's Assistant (CNA), Medical Assistant (MA), or medical terminology course
Responsibilities
- Communicates with ordering providers and nursing regarding insurance authorizations, denials, peer-to-peer review requests and scheduling difficulties with referrals to providers.
- Takes telephone requests for authorizations.
- Prepares referral requests.
- Informs patients of appointment information and instructions.
- Maintains electronic health record (EHR) referral documentation to reflect actions on specific referrals (including adding incoming referrals that were not generated from the electronic health record (HER)).
- Maintains referral resource document.
- Schedules referral appointments with appropriate department or referred to provider.
- Tracks referral patient compliance and communicate with referring provider as necessary regarding patients refusing service and patients not showing up to a referral appointment.
- Submits retroactive authorization requests as needed.
- Performs other job-related duties as assigned.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
5,001-10,000 employees
