Referral Associate - Outpatient, AHHF AHPN Call Center (Full-Time, Day Shift)

Adventist Health•Hanford, CA

1d•Onsite

About The Position

Located in a tight-knit community in Kings County, Adventist Health Hanford has been serving the Central Valley since 1965. We are comprised of a 173-bed hospital and many outpatient clinics with primary and specialty care services. Hanford residents are proud of their city's historic charm and family-friendly atmosphere. Within an hour's travel time, Yosemite, Sequoia and Kings Canyon National Parks can be enjoyed. This role 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. FLSA Status: Non-Exempt.

Requirements

Adheres to the Adventist Health Mission, Vision and Values statements.
Complies with behavioral standards, policies, procedures and handbooks established by the organization and their respective ministries.
Abides by the guiding principles of the Code of Conduct
All associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.
Participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify.
Acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.

Nice To Haves

High School Education/GED or equivalent: Preferred
Associate's/Technical Degree or equivalent combination of education/related experience: Preferred
Certified Nurse's Assistant (CNA), Medical Assistant (MA), or medical terminology course: Preferred
Refer to Job Analysis 05B for details regarding additional ability requirements.

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.