At Shasta Cascade Health Centers, we pride ourselves on being more than just a healthcare provider – we are a family deeply rooted in the communities we serve. Our team is dedicated to delivering compassionate, patient-centered care while fostering a supportive and inclusive workplace culture that encourages growth and collaboration. We believe in empowering our employees to make a meaningful difference in the lives of our patients, as we strive to create an environment where every team member feels valued. If you're looking to join a passionate, close-knit team committed to improving healthcare in a dynamic and fulfilling setting, Shasta Cascade is the place for you!
Job Title: Referral Coordinator
Department: Medical Clinic
Work Division/Location: McCloud/Mt. Shasta/Dunsmuir locations
FLSA Status: Nonexempt
Classification: Full-time
Reports To: Center Operations Manager
Description
Summary/Objective: An employee working as Referral Coordinator with the Shasta Cascade Health Centers is responsible for the coordination, processing and scheduling of medical referrals and prior authorizations for a variety of medical services/procedures for patients as requested by medical providers. As an integral member of the health care team, the Referral Coordinator collaborates with medical providers, nursing staff and other patient care support staff.
Essential Functions:
- Monitors electronic health record (EHR) notifications throughout the day to capture referral requests in real time.
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Prepares and processes referral and pre-authorization paperwork.
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Gathers information as needed via EHR or from the clinical team to accurately complete pre-authorization/referral process.
- Utilizes third party payer/insurance portals; has an understanding of insurance providers, their portals and their expectations for authorization approvals
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Ensures proper use of Current Procedural Terminology (CPT) and current International Classification of Disease (ICD) codes to meet the requirements of third party payers and specialty clinics to ensure minimal delay in securing referral appointments or pre-authorizations.
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Utilizes EHR functions to document all pertinent information.
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May schedule referral appointments directly on behalf of patient.
- May perform referral tracking process utilizing the EHR or other established system.
- Organizes and prioritizes workload effectively.
- Other duties as assigned.
All Clinic employees are expected to:
- Exemplify the meaning of the Clinic’s Mission, Visions and Values.
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Maintain operations by following the Clinic’s policies and procedures, following established safety practices and reporting perceived need/s for changes.
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Provide the highest level of service to clients.
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Maintain confidentiality by following all applicable HIPAA regulations.
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Respect Clinic equipment used to perform job tasks.
Supervisory Responsibilities:
This position has no supervisory responsibilities.
Work Environment:
This job operates in a professional medical clinic environment with potential exposure to blood and body fluids and other hazardous substances. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.
Travel:
No travel is expected for regular job duties. Travel may occasionally be required for training purposes. If personal vehicle is used for specified job-related errands or travel to/from training events, mileage will be reimbursed as specified in the Employee Handbook.
Qualifications
Education, Experience, Certifications, Licenses and Registrations:
- Minimum education: High School diploma or equivalent.
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Preferred education: Graduate of a Medical Assistant Program/Certified Medical Assistant.
- Minimum experience: Medical Assistant with two years’ experience in a clinic setting preferred; or three years’ experience in medical referrals or other related medical patient support functions in a clinic setting.
- Is detailed oriented and works with a high level of accuracy in every aspect of the job.
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Is a team player who demonstrates a caring and compassionate commitment to the patient with sensitivity to the patient’s unique circumstances and needs.
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Demonstrates a high level of interpersonal skills, time management skills, flexibility, and an ability to meet established productivity standards.
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Ability to work collaboratively with multiple health professionals in a busy environment using tact, diplomacy and discipline.
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Ability to understand and adhere to established policies, procedures, protocols of the Clinic, including strict confidentiality requirements.
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Ability to make timely and sound decisions, and to remain calm in emergency situations.
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Ability to proficiently use computers and software programs used by the Clinic.
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Basic Life Support (BLS) certification, or ability to become certified.
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This position requires an awareness of socioeconomic needs and the ability to meet and deal effectively with organizations using tact, courtesy, discretion, resourcefulness and good judgment.
Skills and Competencies:
Verbal and written communication proficiency, ethical conduct, flexibility, initiative, ability to multi-task, time management, highly organized, detail orientated. Customer services skills, sensitivity to client needs, remains calm in emergency situations, upholds strict confidentially requirements. Familiarity with computer processes, including word processing and spreadsheet programs.
Physical Requirements:
The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing job duties, the employee is regularly required to talk and hear. The employee is frequently required to stand, walk, reach with hands and arms, and use hands and fingers.
- Ability to communicate effectively in person, by phone and by email.
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Ability to visually interpret printed materials, memos, and other needed paperwork.
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Ability to lift or move objects weighing up to 25 pounds.
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Ability to sit for long periods of time.
NOTE: Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities of this job at any time.
Shasta Cascade Health Centers is committed to complying with all federal, state, and local laws providing equal employment opportunities, and all other employment laws and regulations. It is our intent to maintain a work environment that is free of unlawful harassment, discrimination, or retaliation based on the following protected classes: age (40 and older), race (including traits associated with race, which include, but are not limited to, hair texture and protective hairstyles such as braids, locs, and twists), color, religion, religious creed (including religious dress and grooming practices), national origin, ancestry, citizenship, physical or mental disability, medical condition (including cancer and genetic characteristics), genetic information, marital status, reproductive health decision-making, sex (including pregnancy, childbirth, breastfeeding, and related medical conditions), gender (including gender identity and gender expression), sexual orientation, veteran and/or military status, protected medical leaves (requesting or approved for leave under the Family and Medical Leave Act or the California Family Rights Act), status as a victim of violence or family member’s status as a victim of violence, political affiliation, off-duty and off-premises use of cannabis, or any other status protected by federal, state, or local laws.
