We have an immediate opening for a Referral & Managed Care Coordinator. The key candidate will have healthcare referrals & managed care plan experience, be detail oriented and a team player.
Language: English and Spanish required.
Regular attendance and on-time arrival are conditions of retention in this position.
In office hours are 8:30 am - 5:00pm
The pay range for this position is $22.15 to $25.00 depending on experience and qualification/education.
JOB SUMMARY:
Working in conjunction with the clinic staff, the Referral and Managed Care Coordinator secures specialist services and referrals, diagnostic tests, and procedures from local healthcare agencies and providers, assuring timely processing of referral requests for patients with and without health insurance. This position informs patients as needed of their referral status and may assist in appointment scheduling. The Referral and Managed Care Coordinator maintains appropriate records and tracks volume of workload for department review. This position is critical in navigating the Utilization review and management of our patient population and to coordinating appropriate follow through to assure compliance and adheres to health insurance utilization regulations.
RESPONSIBILITIES
- Coordinates and manages authorizations for referrals from our primary care providers to outside providers, including to medical specialists and outside facilities for special testing.
- Coordinates and manages authorizations for certain specialists and treatments when this is required by patients' medical insurance plans.
- Facilitates and ensures the receipt of consult notes and test results after a patient has been referred to an outside provider.
- Communicates with primary care provider (PCP) to inform of any delays or barriers to patients care.
- Serves as referral department liaison to outside agencies and partners.
- Communicates with Supervisor when unable to process all referrals or follow-ups to avoid delays.
- Carries out patient discharge processes; clarifies and provides patients with follow up care instructions and referrals.
EDUCATION/QUALIFICATIONS:
- Minimum 1 (one) year experience in healthcare environment with patient interaction, customer service responsibilities and well versed in medical terminology.
- 1 (one) year of referral experience preferred; including working with physicians’ offices, hospitals, managed care and other medical service sites.
- Medical Assistant experience (front or back office) is beneficial by not required
- Demonstrated “detail approach” to all administrative and organizational duties including setting priorities and meeting deadlines.
- Excellent verbal and written communication skills. Must have good listening skills, and be able to effectively and clearly communicate
- Bilingual in English and Spanish
- Must be well versed in HIPAA laws with regard to medical records.
- Works successfully and respectfully with our vulnerable patients population which includes patients with diverse backgrounds and cultures; mentally ill patients, patients experiencing homelessness, substance abuse patients, etc.
- Proficient Use of Microsoft Products (Word, Excel, Outlook) Internet, and Practice Management Systems.
- Uses electronic medical record software (Epic); develops proficiency within 3 months of training
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What do we offer? A competitive salary and a generous benefits package for our full time team members which includes Health Insurance options covered at 100% or 90% of cost for team members and 50% for eligible dependents; We have group Medical, Dental and Vision, Flexible Spending Accounts, Basic Life insurance/AD &D, Voluntary Life Options, Long Term Disability, 403b Retirement Plan with employer match, Employee Assistance Program, Global Travel Assistance, Supplemental Accident, Critical Illness and Hospitalization plans offered offered, Tuition Reimbursement Program, 10 Paid Holidays, 10 Paid Vacation and 6 Sick Days.
All qualified candidates will be subject to an employment & criminal background check and must be able to provide proof of required Immunizations for healthcare facility. We will provide vaccines to new employee's if needed at no cost.
JobReq#: 202603RMCC1
Job Type: Full-time
Pay: $22.15 - $25.00 per hour
Benefits:
- 403(b) matching
- Dental insurance
- Disability insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Tuition reimbursement
- Vision insurance
Experience:
- Healthcare: 1 year (Preferred)
- Healthcare Referrals: 1 year (Preferred)
Language:
Ability to Commute:
- Newport Beach, CA 92660 (Required)
Work Location: In person
