Referrals - Referral Coordinator

Unicare Community Health Center Inc, Recruiter•Fontana, CA

6d•$25 - $30•Hybrid

About The Position

The Referral Coordinator I is responsible for coordinating care between medical providers and specialists to ensure patients receive appropriate care. This role involves managing the entire referral process from submission to follow-up, ensuring adherence to insurance requirements, and maintaining accurate documentation. The coordinator will also assist patients with navigating the healthcare system, addressing barriers, and acting as a liaison with external resources.

Requirements

High school diploma or GED required.
One (1) to two (2) years referral experience.
Bilingual in English/Spanish required.
Excellent people skills, with an ability to partner with a dynamic leadership team.
Possess personal qualities of integrity, credibility, and commitment to corporate mission.
Flexible and able to multitask; can work within an ambiguous, fast-moving environment, while also driving toward clarity and solutions; demonstrated resourcefulness in setting priorities.
Strong customer service focus.
Effective verbal and written communication skills.
Teamwork orientation.
Organized and able to manage competing priorities.
Good judgment.
Resourcefulness in problem solving.
Able to take and follow through with delegated tasks and accountability.
Must have reliable transportation.
Adhere to dress code, appearance is neat and clean.
Maintain patient confidentiality at all times.
Report to work on time and as scheduled.
Maintain regulatory requirements, including all state, federal and local regulations.
Represent the organization in a positive and professional manner at all times.
Comply with all organizational policies and standards regarding ethical business practices.
Communicate the mission, ethics and goals of the organization.
Participate in performance improvement and continuous quality improvement activities.

Nice To Haves

Medical assistant certification preferred.

Responsibilities

Processing referrals submitted by health care providers in all referral queues.
Completing the referral life cycle: submit, approve, notify patient, follow-up, and secure medical records within identified time periods.
Adhering to insurance requirements and communicating with clinicians for clinical care needs.
Maintaining ongoing tracking and appropriate documentation on referrals using an EHR database.
Ensuring complete and accurate registration, including patient demographic and insurance information.
Assembling information concerning patient's clinical background and referral needs.
Providing appropriate clinical information to specialists per referral guidelines.
Contacting review organizations and insurance companies to ensure prior approval requirements are met.
Presenting necessary medical information such as history, diagnosis, and prognosis.
Providing specific medical information to financial services to maximize reimbursement.
Reviewing referral details and expectations with patients.
Assisting patients with problem-solving potential issues related to the healthcare system, financial or social barriers (e.g., requesting interpreters, transportation services, or prescription assistance).
Acting as a system navigator and point of contact for patients and families.
Advocating on the patient's behalf with carriers to ensure timely approval of necessary supplies/services.
Identifying and utilizing cultural and community resources.
Establishing and maintaining relationships with identified service providers.
Ensuring referrals are addressed in a timely manner.
Reminding patients of scheduled appointments via mail or phone.
Ensuring primary care charts are updated with information on specialist consults, hospitalizations, ER visits, and community organization involvement related to patient health.
Performing other related and/or necessary tasks as directed by the Referral Supervisor.