Referral Associate, Full Time, Days

Adventist Health

6h

About The Position

Nestled on the Central California Coast, Adventist Health Sierra Vista has been providing care to our community since 1959. Our 162-bed acute care facility includes a Level III Neonatal Intensive Care Unit and county designated trauma center. San Luis Obispo offers the excitement of a lively community while being a fifteen-minute drive from the serenity of Avila Beach, known for their natural hot springs, and Pismo Beach, known for their sand dunes and eucalyptus trees. Featuring a charming downtown, comfortable coastal weather, idyllic views, and an active lifestyle San Luis Obispo offers much to be had. Job Summary: Coordinates and completes referrals 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED