Under the direction of the Referral Authorization Manager, the position assists patients with referral needs and to connect patient services with outside resources.
Essential Duties and Responsibilities:
- Process referrals for insured and uninsured patients throughout Los Angeles County utilizing Medpoint System for insured patients and the Referral Processing System (RPS) and eConsult for uninsured patients.
- And uninsured patients for mammography will be referred to in-house service provided by outside agency.
- Process referrals with private insurances HMO and PPO.
- Verify patient insurance status whether patient have insurance or not.
- If patient is insured, check eligibility to determine specialist’s resource.
- If patient is uninsured, chose public resource.
- Refer for in-house service such as retinal screening and telederm for uninsured patient.
- Communicate daily with Health Care LA IPA, RPS system and eCounsult to check status.
- Upon approval for referral request, notice to patient appropriately such as phone and mail. And send necessary document to specialist by fax.
- Request report from specialists and the report will be scanned into eCW and assigned to appropriate physician.
- For mammogram and retinal screening, patient will be referred to specialist for necessary treatment according to the report.
- Each referral clerk documents all the process in ecw until we receive the report. And record necessary information to keep track on referral status on our own.
- Attend monthly meetings addressing utilization management for Health Care LA IPA , eConsult and RPS system. (for designated staff only)
- Responsible for a monthly report to measure productivity.
- Other duties as assigned.
Qualifications and Experience Requirements:
- High School Diploma or equivalent preferred.
- Experience in a community clinic preferred.
- Knowledge in Medical Terminology
- Ability to work with people of diverse cultural, educational, social, and economic backgrounds
- Excellent oral and written communication skills
- Excellent organizational skills
- Computer proficiency
- Experience utilizing an Electronic Medical Records (EMR) system is highly desirable
- Bilingual in Spanish required.
Job Type: Full-time
Pay: $22.00 - $25.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Disability insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Experience:
- Referral: 1 year (Required)
Language:
Work Location: In person
