Referral Clerk

THE HEALTH AND WELLNESS CENTERS, INC.•Los Angeles, CA

8d•$22 - $25•Onsite

About The Position

Under the direction of the Referral Supervisor, the position assists patients with referral needs and to connect patient services with outside resources. The Referral Clerk will process referrals for insured and uninsured patients throughout Los Angeles County utilizing Medpoint System for insured patients and the Referral Processing System (RPS) and eConsult for uninsured patients. Mammograms for uninsured patients will be referred to an in-house service provided by an outside agency. The role involves processing referrals with private insurances HMO and PPO, verifying patient insurance status, checking eligibility for specialist resources for insured patients, and selecting public resources for uninsured patients. The clerk will also refer patients for in-house services like retinal screening and telederm for uninsured patients. Daily communication with Health Care LA IPA, RPS system, and eConsult is required to check status. Upon approval of a referral request, patients will be notified appropriately via phone and mail, and necessary documents will be sent to specialists by fax. The clerk will request reports from specialists, scan them into eCW, and assign them to the appropriate physician. For mammograms and retinal screenings, patients will be referred to specialists for necessary treatment based on the report. Each referral clerk documents all processes in eCW until the report is received and records necessary information to track referral status. The position also requires attending monthly meetings addressing utilization management for Health Care LA IPA, eConsult, and RPS system (for designated staff only) and is responsible for a monthly report to measure productivity. Other duties as assigned.

Requirements

High School Diploma or equivalent preferred.
Experience in a community clinic preferred.
Knowledge in Medical Terminology
Ability to work with people of diverse cultural, educational, social, and economic backgrounds
Excellent oral and written communication skills
Excellent organizational skills
Computer proficiency
Experience utilizing an Electronic Medical Records (EMR) system is highly desirable
Bilingual Required

Responsibilities

Process referrals for insured and uninsured patients throughout Los Angeles County utilizing Medpoint System for insured patients and the Referral Processing System (RPS) and eConsult for uninsured patients.
Process referrals with private insurances HMO and PPO.
Verify patient insurance status whether patient have insurance or not.
Check eligibility to determine specialist’s resource for insured patients.
Chose public resource for uninsured patients.
Refer for in-house service such as retinal screening and telederm for uninsured patient.
Communicate daily with Health Care LA IPA, RPS system and eCounsult to check status.
Upon approval for referral request, notice to patient appropriately such as phone and mail.
Send necessary document to specialist by fax.
Request report from specialists and the report will be scanned into eCW and assigned to appropriate physician.
Refer patient to specialist for necessary treatment according to the report for mammogram and retinal screening.
Document all the process in ecw until we receive the report.
Record necessary information to keep track on referral status on our own.
Attend monthly meetings addressing utilization management for Health Care LA IPA , eConsult and RPS system. (for designated staff only)
Responsible for a monthly report to measure productivity.
Other duties as assigned.