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Position Title: Referrals Coordinator
Position Status: Non-Exempt
Reports To: Practice Administrator
General Summary: A non-exempt clerical position responsible for processing all provider generated referrals including but not limited to; submitting authorization requests to appropriate health plans, contacting referred provider, patient and ensuring patient completes referral appointment in order to ensure continuity of care for SDIMA patients.
Location: This position is located in Kearny Mesa, San Diego County.
Status: Full time, day shift
Salary: Hourly, DOE
• Process referrals from primary care providers in a timely manner, prioritize the referrals according to defined levels of urgency, communicate referral information to patients.
• Submit HMO, Military, and PPO imaging authorizations to insurances.
• Submit medication prior authorizations.
• Verify insurance eligibility.
• Fax all necessary paperwork to specialists (ex: chart notes, labs, prior imaging, medication lists, insurance card, patient demographic, orders, etc.) as well as documenting what was faxed and when.
• Work with the Primary Care Provider to work on re-processing authorization denials.
• Collect information concerning patient’s clinical background and referral needs. Per referral guidelines, provide appropriate clinical information to reviewing clinicians and specialists. Present necessary medical information such as history, diagnosis and prognosis.
• Contact review organizations and insurance companies to ensure prior approval requirements are met.
• Must exercise utmost diplomacy and tact to provide excellent customer service for patients; practices confidentiality and privacy protocols in accordance to Clinic policies and HIPAA requirements.
• Work with your team in order to complete all areas of referrals and provide backup to team members as needed.
• Incorporates SDIMA’s 10 Must Haves of Service Excellence (SDIMA AIDET) (Safety, Discreet, Impeccable, Mindful, Accountable, Acknowledge, Introduce, Duration, Explain, Thank) into all patient and customer interactions.
• Other duties as assigned.
Required Skills and Qualifications
• Medical Assistant training/certification preferred may be substituted with 2-3 years of medical office experience with a strong emphasis in customer service, computer skills, data entry, phones, and an understanding/usage of medical terminology.
• Knowledge of CPT and ICDC-10 codes.
• Experience with and proficiency in use of electronic medical record systems.
• Proficient computer skills and accuracy of data entry
• Organize and prioritize work activities.
• Excellent organizational and time management skills.
• Ability to multitask, managing multiple items with attention to detail and meeting deadlines.
• Excellent analytical and problem-solving skills in order to improve department efficiency.
• Communicate and discuss personal matters with patients and/or their representatives.
• Communicate effectively and concisely with all departments, providers, and coworkers both verbally and in writing.
• Communicate professionally with other referral team members and provide the necessary support for the department.
• High school diploma or equivalent required.
• Medical Terminology required.
• Competitive wages.
• Medical, vision, and dental insurance.
• Paid Holidays
• Paid vacation time.
• Paid sick leave.
External hires must pass a background check. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.
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