Temporary Referral Clerk I - 34th Street CHC

Clinica Sierra Vista•Bakersfield, CA

16d

About The Position

Under the direction of the Referral Supervisor or Referral Manager, the Referral Clerk I is responsible for the coordination, processing, and scheduling of specialty referrals, and prior authorizations for a variety of medical services/procedures for patients as requested by the primary care physician. As an integral member of the patient’s health home, the Referral Clerk will collaborate with medical providers, nursing staff, and other patient care support staff to ensure patients receive specialty services timely and efficiently in alignment with department of health care guidelines.

Requirements

Graduation from High School or equivalent GED.
Two (2) to three (3) years medical back office or administrative medical experience in a community healthcare preferred but not required.
Intermediate computer skills required.
Must adhere to Clinic Sierra Vista’s employee health/immunization requirements or provide a valid exemption request for subsequent approval.

Nice To Haves

Graduate of an accredited Medical Assistant program preferred.
Bilingual in Spanish preferred but not required.
Previous experience with specialty referrals in community health desired.

Responsibilities

Schedules, problem solves, communicates, and coordinates referral appointments with outside specialists.
Tracks and enters all referral requests in the Referral Tracking System or EMR daily.
Coordinates with the HIM staff to track the status of all provider reports on patients referred to hospitals, outside clinics and Specialty Providers and follow up for reports/records not received on referred patients.
Maintains an accurate record(s) of external referral patient’s appointments that are kept, failed, and current status in the Referral Tracking System or EMR (EPI; Monitors Referral Tracking System or EMR for outstanding provider reports that are (30 days or older), and follows-up with the appropriate provider.
Verifies insurance information for referral purposes and processes insurance information for referral patients.
Provides transportation consultation, coordination, and support to clinic patients referred to specified health care facilities, (This includes clinic provided (if applicable), Insurance and Cab based support).
Answers, responds, and documents phone calls, requests, and questions from patients in a timely manner. Calls must be accurately managed or redirect as appropriate.
Utilizes third party payer/insurance portals; understands insurance providers, their portals and their expectations for authorization approvals.
Ensures proper use of CPT and current ICD-10 codes to meet the requirements of third-party payers and specialty clinics to ensure minimal delay in securing referral appointments or pre-authorizations.
Utilizes EHR (EPIC) functions to document all pertinent information.
May perform referral tracking process utilizing the HER (EPIC) or other established system.
Other duties as assigned. Please see attachment for full job description.