Referral Specialist jobs in Sacramento, CA

Description

Join Elica’s mission and become a part of a team where every day is an opportunity to make a positive impact in your community!

At Elica Health Centers, we share a common goal: provide the best possible patient care to our growing community! Our passion extends throughout Elica, from the exceptional healthcare services we provide to our underserved patients at our Community Health Clinics and state-of-the-art mobile medicine program, Health on Wheels, to our Resource Center where we empower patients and members of the community to connect with resources to help them build healthy and full lives.

WHAT YOU'LL DO:

The Referral Coordinator is responsible for coordinating specialty care for patients in need of external consultation as requested by the provider. Responsibilities will also include obtaining authorization, tracking and maintaining appropriate documentation to support both providers and patients. Coordinates and ensures the smooth flow of the referral and authorization process to meet the needs of our patients, establish collaborative relationships with community specialists and insurance companies, and represent the organization professionally and positively.

BENEFITS:

Elica is proud to offer an exciting benefits package to qualifying full-time employees which can support your health, your family, and help you plan for the future.

• Healthcare: Medical (Kaiser or Western Health Advantage), Dental, Vision
• Company funded Health Reimbursement Arrangement (HRA) to help pay for out-of-pocket costs related to medical coverage
• FSA Plans: 2 options for Flexible Spending Accounts - Health Care FSA and Dependent Care FSA
• 403B retirement savings account with up to 4% employer matching contribution and 100% immediate vesting.
• Company paid basic Life and AD&D Insurance. (supplemental life and AD&D options available)
• Paid time off and paid holidays.
• Employee Assistance Plan with five (5) free counseling visits, financial services, legal services, and a plethora of online resources.
• Tuition Reimbursement program and CME/CEU program.

Learn more about Elica’s services and mission at our website or check us out on Facebook.

Requirements

WHAT ARE WE LOOKING FOR?

The successful candidate will be willing and able to:

• Coordinate the authorization and referral process for each assigned referral.
• Process referrals for requested services, ensuring timely and thorough completion.
• Monitor referral requests for completeness and take appropriate steps to review, request and obtain additional information when requested services are incomplete or inconsistent with scope of service.
• Assist providers, Patients and/or internal customers with cases pertaining to referral questions, issues and authorizations
• Provide accurate data entry of referral or authorization information into the electronic medical record.
• Send complete information to patient' insurance (when applicable) and referring specialist in order to coordinate referral.
• Consistently utilize the department's documentation protocols.
• Maintain ongoing tracking and appropriate documentation on referrals to promote team awareness and ensure patient safety.
• Ensure referral is completed according to the department guidelines and within the appropriate time frame.
• Make outreach efforts to insurances, patient, specialist office and care team as set forth by department guidelines and clinical priorities.
• Handle telephone calls in a friendly, courteous and sensitive manner.
• Return calls and follow up in a timely manner.
• Interacts collaboratively with clinical staff, other ancillary departments, and outside entities (specialist office, insurances, etc.).
• Resolves differences in a spirit of cooperation and creates solutions, which benefits all parties, especially clinic patients.
• Assist and support the Center/Department/Program to meet standards of high reliability.
• Performs other related duties as indicated or when requested by the manager.

The successful Candidate has:

• High School Diploma or GED Equivalent
• Completion of a formal Medical Assistant or Medical Office Assistant program preferred or demonstrated comparable combination of training and experience.
• One (1) year of experience preferred in referrals or patient services in a medical clinic or healthcare setting
• Prior experience using Electronic Health Records systems- Epic Preferred
• Requires knowledge of medical and billing terminology (ICD-9/10 and CPT codes).
• Requires understanding of health insurance concepts and requirements, including HMO, PPO, Medicare, Medi-Cal, and other federal and state agency programs.
• Ability to work with minimal supervision and use good judgment, at times under the pressure of deadlines
• Commitment to HIPAA, maintaining and abiding by standards of professional ethics and confidentiality.
• Demonstrated commitment to the provision of services for the underserved and sensitivity working with a variety of people from low-income populations, with diverse educational, lifestyle, ethnic, and cultural origins; disabled, homeless, substance users, HIV (AIDS) infected, and/or physiologically impaired.
• Adherence to all Elica policies including but not limited to: standards of conduct, time and attendance, and infection control procedures and social distancing policies.

Additional Requirements:

• Must have a current and valid California driver’s license and the ability to provide proof of personal auto insurance on the vehicle driven during working hours.
• If selected for an employment opportunity with Elica Health Centers, external hires must provide proof of immunizations (Hepatitis B, MMR, Varicella & Tetanus), tuberculosis clearance, and proof of COVID-19 vaccination status* prior to their scheduled start date. Please be advised that this position is subject to criminal background investigation and drug screen.

Physical Requirements and Work Environment:

The work environment is characteristic of normal office conditions. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is frequently required to sit; use hands to handle or lift. The employee is occasionally required to stand; walk; and reach with hands and arms. The employee must occasionally lift and/or move up to 20 pounds. Specific vision abilities required by this job include close vision, distance vision and ability to adjust focus. The employee must also possess hearing and speech to communicate in person and over the phone. The noise level in the work environment is usually quiet. The employee may be required to run agency related errands and attend off-site meetings; the employee must be able to operate, maneuver and/or control a motor vehicle. In performing the driving responsibilities, the driver may sit for long periods. This requires intense concentration, particularly in poor driving conditions.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

*Elica Health Centers is a healthcare facility that adheres to the mandates issued by the California Department of Public Health including the recent orders regarding the COVID-19 vaccine. Medical and religious exemptions will be considered.

Compensation - Dependent Upon Experience

$20.00 - $26.00 an hour