Referral Clerk

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

3d•$22 - $25

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. Essential Duties and 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. And uninsured patients for mammography will be referred to in-house service provided by outside agency. Process referrals with private insurances HMO and PPO. Verify patient insurance status whether patient have insurance or not. If patient is insured, check eligibility to determine specialist’s resource. If patient is uninsured, chose public resource. 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. And send necessary document to specialist by fax. Request report from specialists and the report will be scanned into eCW and assigned to appropriate physician. For mammogram and retinal screening, patient will be referred to specialist for necessary treatment according to the report. Each referral clerk documents all the process in ecw until we receive the report. And 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.

Requirements

High School Diploma or equivalent 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

Nice To Haves

Experience in a community clinic preferred.

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.
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.
Request report from specialists and the report will be scanned into eCW and assigned to appropriate physician.
Each referral clerk documents all the process in ecw until we receive the report.
Attend monthly meetings addressing utilization management for Health Care LA IPA , eConsult and RPS system.
Responsible for a monthly report to measure productivity.
Other duties as assigned.