Referral Clerk

NORTHEAST COMMUNITY CLINIC•Los Angeles, CA

10h•$23 - $28

About The Position

The Referral Clerk is responsible for verifying eligibility, checking benefits, documenting physician direct referrals and preauthorization of certain services, via phone, fax or e-mail. This position will also be responsible for scheduling appointments with specialist and other community resources as instructed by primary care provider.

Requirements

Microsoft Office/Word/Excel/Outlook
Excellent Communication Skills
Excellent Customer Service Skills
Bi-lingual Spanish/English preferred
Ability to work as a team player and work independently
Reliable transportation
Must be able to travel from facility to facility
This position requires 10 % travel outside the local area.
High school diploma or GED equivalent
Minimum 0.5 years of positional experience
Commitment to goals and philosophy of Northeast Community Clinic
Current CPR and/or BLS Certification
Valid State Identification

Nice To Haves

Medical Assistant Certificate or Certified Medical Assistant (Preferred)
Billing Certificate or Understanding of Medical concept

Responsibilities

Process HMO, PPP, EAPC, CHDP and other specialty referrals
Completion of authorization request form
Fax or e-mail referral request to respective IPA/Health Plan, County and etc. along with the required pertinent information to support the request.
Notify patients (if necessary) regarding authorization decision; approved or denied
Schedule appointments with Specialists and notify patients
Follow up status on referrals for completion
No show- reschedule
Follow-up visit(s) either with Specialist or PCP
Consultation Reports
Responsible for filing completed referral forms in the medical charts
Maintain referral logs per financial class, i.e., HMO, PPP, etc.
Weekly report to QM on specialty utilization
Comply with the IPA, Health Plan and/or Programs UM Protocols
Ensures HIPAA Compliance at all times
Work closely with Clinic Providers and maintain communication on referral status
Review and maintain referral log
Act as liaison between clinic and managed care department
Other duties as assigned by supervisor