Referral Coordinator

Job DetailsJob Location: Indian Health Council-Rincon - Valley Center, CA 92082Position Type: Full TimeSalary Range: $23.09 - $25.17 HourlyTravel Percentage: NoneJob Shift: Day 8:00-4:30Job Category: Admin - ClericalSince 1970, Indian Health Council, Inc. (IHC) has provided high-quality, compassionate healthcare and support services to the nine Federally recognized American Indian tribes in north San Diego County. With more than 200 employees serving 2 clinic sites, IHC is proud of the diversity of its staff as a reflection of the community it serves. The reward of working at IHC is more than a paycheck and excellent benefits; it is the impact and contribution to the Tribal community that employees value most. If you are passionate about improving the overall health and wellness of our tribal community, IHC is looking for people like you.   About Us • Patient-Centered Care: Medical, Dental, Behavioral Health, Pharmacy, Social Services • Research focused: Community Based Participatory grant-funded research programs; we are a Native American Research Center of Health (NARCH). • Accredited as an ambulatory health care center by AAAHC Our Philosophy At IHC, we believe in empowering our patients with knowledge to achieve their healthcare goals. We strive to treat the whole person using a multifaceted approach to include physical, mental, emotional, and spiritual aspects of health and wellbeing.   Our Benefits PPO medical, dental, and vision insurance with low employee contribution; company-paid life and disability insurance; malpractice coverage for providers; 403B retirement with company matching; generous PTO and Sick time; 14 paid holidays; paid jury service; and paid bereavement leave; reimbursement for professional license(s), and certifications such as CPR and continuing education units. Our facility also qualifies as a high-need area for provider CA State and Federal Loan Repayment Programs.   Reports To: Referral Manager FLSA Status: Non- Exempt Position Function: Non-clinical Classification: Regular, Full-time Schedule: Monday – Friday or 9/80 schedule available  Location: Onsite, position may be assigned to work at both IHC locations   SUMMARY: The referral coordinator ensures that patient referrals are processed and followed from the time the referral is written until the time the patient completes the referral process. The referral coordinator assists with tracking, coordinates care, communicates with patients and providers, and helps trouble shoot any problems patients may have during the referral process.   ESSENTIAL DUTIES AND RESPONSIBILITIES: The information in this job description indicates the general nature and level of work performed. It is not designed to be interpreted as a comprehensive inventory of all duties and responsibilities required of employees assigned to this job position. Duties and responsibilities may change (be assigned or removed) at any time with or without notice. 1. Assist with referral follow up: a. Make phone calls to patients or facility b. Send letters to patients c. Request reports d. Notify PCP if critical referrals are not completed by patient and document in referral template or phone template e. Close out referrals 2. Process referrals: a. Put together referral packets b. Verify insurance c. Notify patient by phone and letter d. Document phone calls and letters sent in referral template e. Obtain authorization for Diagnostic studies f. Complete PHI Log for all referrals 3. Communicate with Eligibility and Contract Care regarding authorizations for referrals or denials for PRC patients; and makes sure patients complete screening once emergency PO is given. 4. May assist with contacting facilities contracted with IHC. 5. Work in EPIC program in referral work Que. 6. Act as back-up for transportation coordinator as needed. 7. Attend meetings and sessions as required. 8. Assist in the training of new staff, volunteers, or students in the referral dept. 9. Perform other related duties as required by supervisor. 10. Provide back up for obtaining authorization for PRC and TARs for diagnostic studies. 11. Audit referrals to make sure ICD 10 codes and CPT codes are appropriate for each referral. 12. Provide excellent customer service by responding to calls in a timely manner (within the same day or morning of next business day) and uses good customer service skills. 13. Position may be re-assigned during activation of EOP.   SUPERVISORY RESPONSIBILITIES This position has no supervisory responsibilities.   TRAVEL & DRIVING REQUIREMENTS • Travel is not required for this position. • Driving is not required for this position.   EDUCATION AND/OR EXPERIENCE • High School Diploma or GED required. • One (1) years’ experience in social services and/or case management. Project management experience preferred. • One (1) year experience as a Medical Assistant in Adult Medicine or Pediatrics. • Experience in Quality Assurance and/or Utilization Management.   REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES • Knowledge of medical referral best practices. • Knowledge of basic medical terminology, anatomy, and types of medical specialties. • Knowledge of organizational policies, procedures, and systems. • Knowledge of office management techniques and practices. • Knowledge of computer systems and applications. • Knowledge of research methods and procedures sufficient to compile data and prepare reports. • Knowledge of grammar, spelling and punctuation. • Ability to establish and maintain effective working relationships with other employees and the public. • Ability to read, interpret and apply clinic policies and procedures. • Ability to identify problems and recommend solutions. • Ability to establish priorities and coordinate work activities. • Productivity Software: Microsoft Office 365; Word, Excel, PowerPoint, Email & Calendar Management (outlook), Teams (video conferencing and meetings), and Share Point. • Electronic health records software (EPIC preferred). • Utilization of Paycom and PolicyTech systems.   CERTIFICATES, LICENSES, MEMBERSHIPS AND REGULATIONS · Current AED CPR certification or attainment within 6 months of hire. · Applicants must successfully pass a pre-employment physical exam, tuberculin skin test or x-ray and urine drug screen test. · Health must be adequate to perform all duties of the position. · Must pass criminal background check.   WORK ENVIRONMENT The work environment characteristics described are representative of those an employee encounters while performing the essential functions of this job. · Indoor office environment.   PHYSICAL DEMANDS 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 position. While performing the duties of this job, the employee is regularly required to sit, use hands to finger, handle, or feel; reach with hands and arms; and talk or hear. The employee frequently is required to sit. The employee must regularly lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, peripheral vision, and the ability to adjust focus.   CUSTOMER RELATIONS 1. Respond promptly and with caring actions to patients and employees. 2. Maintain professional working relationships with all levels of staff, patients, and the public. 3. Be part of a team and cooperate in accomplishing department/organizational goals and objectives.   QUALITY MANAGEMENT 1. Display knowledge of normal signs of human development and ability to assess and provide age-appropriate care. 2. Contribute to the success of the organization by participating in quality improvement activities.   SAFETY 1. Maintain current knowledge of policies and procedures as they relate to safe work practices. 2. Follow all safety procedures and report unsafe conditions. 3. Use appropriate body mechanics to ensure an injury free environment. 4. Follow all infection control procedures including blood-borne pathogen protocols.   HIPAA/COMPLIANCE 1. Maintain privacy of all patient, employee, and volunteer information. Access such information only on a need-to-know basis and for business purposes only. 2. Comply with all regulations regarding corporate integrity and security obligations. 3. Report unethical, fraudulent, or unlawful behavior or activity.   Indian Preference shall be given in accordance with IHC’s Policies and Procedures. Qualifications