Referral Specialist

Salud Para La Gente • Interlaken, CA

1d • $23 - $28

About The Position

Under the direct supervision of the Health Records and Referrals Manager, the Referral Specialist oversees specialty referral program services across all Salud sites. The role includes meeting with, educating, and following up with patients about referral services and communicating with patients, families, staff, volunteers, and physicians in a manner focused on quality client service. The specialist is responsible for timely referral processing, accurate entry into patients’ Electronic Health Records (EHRs), and follow-up.

Requirements

• High school graduate.
• At least two years of general experience in a healthcare environment, or at least one year of general healthcare experience; one year of referral-processing experience is preferred.
• Bilingual English/Spanish required.
• Basic computer knowledge, including MS Word, Excel, Outlook, and electronic health records.
• Ability to interact and communicate effectively with patients and maintain a pleasant demeanor with angry or frustrated callers.
• Excellent communication, customer service, and telephone skills.
• Strong organizational skills; ability to multitask effectively, work efficiently under stress, and maintain attention to detail.
• Strong sense of teamwork.
• Ability to understand and carry out oral and written directions, maintain patient confidentiality, and follow policies and procedures.
• Ability to work a flexible schedule and at different locations.
• Ability to relate to individuals at all organizational levels and perform daily procedures to high quality standards.
• Ability to use independent judgment while following compliance standards and regulations.

Nice To Haves

• Completed and passed a Medical Terminology course.
• Knowledge of ICD-10.
• Excellent oral and written communication skills.
• One year of referral-processing experience.

Responsibilities

• Follow medical provider orders and complete referral follow-through in a timely and effective manner.
• Coordinate and process STAT/URGENT referrals within 24 hours for patients with critical healthcare needs.
• Coordinate and process routine referrals within five business days.
• Monitor and follow up on the EHR referral queue, closing open orders through a 30-, 60-, and 90-day review system.
• Notify patients of appointments and locations and assist with scheduling interpretation and transportation services; provide follow-up instructions as needed.
• Verify eligibility by obtaining a RAF, TAR, or other documentation.
• Ensure complete and accurate patient registration, including demographic and current insurance information.
• Assemble information about patients’ clinical backgrounds and referral needs and provide appropriate clinical information to specialists according to referral guidelines.
• Maintain ongoing referral tracking and documentation to promote team awareness and patient safety, including use of appropriate EHR tasks and notes.
• Contact review organizations and insurance companies to meet prior-approval requirements; present relevant medical information and assist with financial information for charity or uninsured programs.
• Review referral details and expectations with patients and respond to their referral inquiries in a timely manner.
• Train staff as needed on new referral systems.
• Verify insurance eligibility and pending authorizations, follow up as needed, and identify additional assistance for uninsured or underinsured families.
• Organize pediatric and adult referral scheduling and prepare paperwork and records in anticipation of provider needs.
• Liaise among patients, providers, outside clinics, and hospitals regarding scheduling and follow-up for emergent and short-term cases.
• Communicate information to appropriate resources by computer, phone, fax, and in writing.
• Continuously reprioritize work to accommodate changes.
• Establish, update, and maintain a computer-based referral tracking system.
• Use a computer to enter or retrieve information and generate reports as needed.
• When time allows, assist with assignments and cover for other staff members in their absence.
• Maintain effective working relationships with staff, managers, providers, and the community.
• Perform other referrals department duties as assigned.
• Work effectively in a fast-paced environment with people from diverse cultural backgrounds.
• Conduct activities politely, courteously, and professionally, and abide by company policies and procedures.

Benefits

• Medical, dental, vision, and life insurance plans.
• Paid time off: 19 days per year.
• Paid holidays: 13.5 per year.
• 401(k) retirement plan with employer contribution.
• Voluntary long-term disability.
• Benefits are available to regular Salud employees working 24 or more hours per week; part-time employees may receive some benefits on a prorated basis.
• Employees on temporary assignments are eligible for holiday pay and California sick pay, prorated based on hours worked.
• On-call employees are eligible for California sick pay, prorated based on hours worked.

What This Job Offers

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