Referral Clerk

Where You’ll Work

Founded in 1951, Dignity Health - Mark Twain Medical Center is a 25-bed, acute care, nonprofit hospital located in San Andreas, California. Serving over 90,000 patients annually, the hospital offers a full complement of services including cancer care, emergency care, and orthopedics. Mark Twain Medical Center also includes four Family Medical Clinics offering exams, immunizations, and care for minor injuries. Additionally, Mark Twain Medical Center has been recognized as an LGBTQ+ Healthcare Equality High Performer by the Human Rights Campaign Foundation.It is the only medical facility in Calavaras County.

One Community. One Mission. One California 

Job Summary and Responsibilities

As our Referral Clerk, you will help family medical centers streamline insurance authorization and referral processes so they can enhance patient care efficiency and financial reimbursement.

Every day you will coordinate insurance authorizations, referrals, and TARS for all family medical centers. You will be expected to process physician referral orders, maintain accurate tracking documentation, and effectively communicate with patients, insurance carriers, and healthcare providers.

To be successful in this role, you will have proven experience in medical terminology, navigating healthcare systems, and resolving patient-related issues.

• Receive, track and obtain insurance authorization from insurance carriers. Process physician referral orders (CT, MRI, NUC Med, etc).
• Demonstrates knowledge of medical terminology, high proficiency of general medical office procedures and adheres to HIPPA regulations.
• Maintain ongoing tracking and appropriate documentation on referrals to ensure patient safety.
• Assemble information concerning patient's clinical background and referral needs per referral guidelines, provide appropriate clinical information to specialist. Contact review organizations and insurance companies to ensure prior approval requirements are met.
• Present necessary medical information such as history, diagnosis and prognosis. Provide specific medical information to financial services to maximize reimbursement to the hospital and physicians.
• Assist patients in problem solving potential issues related to the health care system, financial or social barriers. Addresses questions from patients via telephone related to outpatient appointments and procedures.

Job Requirements

Required

• High School Graduate or GED
• Minimum 1 year of experience working in a hospital Patient Registration department, physician office setting, healthcare insurance company, revenue cycle vendor, and/or other revenue cycle related roles