Position – Referrals Coordinator
Department – Referrals
Schedule – Monday- Friday 8:00am – 5:00 pm
SAC Health System is dedicated to reflect the healing ministry & love of Jesus Christ through healthcare, education & partnerships that empower our communities to flourish
SACHS Core Values:
Quality Healthcare – providing patient-centered, culturally-sensitive, equitable care that is safe, timely, effective, efficient, while seeking to prevent illness & disability
Teamwork – working together to achieve a common goal, with a willingness to serve each other in a Christ-like manner
Wholeness – ministering to the spiritual, physical, mental & emotional needs of others
Integrity – living & working in an authentic, honest way that inspires trust
Compassion – engaging with the needs & suffering of others, out of concern for their wellbeing
Excellence – striving to exceed expectations for our patients, community, & staff
Humble Service – caring with a kind & selfless spirit
Respect – holding others in high regard by empowering them
Requirements for Success in Your Role:
Understands the referral/authorization process for multiple payer sources. Offers guidance to providers on the ordering of referrals as needed. Processes and ensures completion of referral orders to specialists. Works under the supervision of the Referrals Supervisor to ensure accurate and timely review and processing of authorizations. Requires exceptional accuracy, organization, communication and office, and interpersonal skills. Performs other duties as needed.
Essential Functions and Deliverables
- Processes incoming referral requests daily.
- Reviews referral orders for accuracy of codes and supporting documentation.
- Receives, processes and verifies accuracy of authorizations.
- Receives and processes specialty notes to primary care physician to facilitate on-going authorizations for continued care.
- Serves as liaison and authorization resource to clinic staff, outside medical groups and patients.
- Knowledgeable and familiar with insurance policies, referral, and authorization processes. Works with insurance companies / managed care groups to ensure pre-visit information is sent to patients as needed.
- Utilizes exceptional customer service skills in performing duties and assists with problematic referral and authorization process. Ability to resolve problems in a timely manner.
- Recommends improvements to department processes as appropriate.
- Contacts insurance company(s) to verify patient eligibility and benefits.
- Contacts patients as needed to update demographics. Informs patients/guarantors of their financial responsibility for scheduled services.
- Informs patients and/or clinic the staff of any insurance problems affecting future services.
- Develops and maintains professional working relationships with outside providers, vendors and insurance groups involved in the referral process. Ability to work cohesively with all other SACHS departments.
- Maintains an accurate and up-to-date tracking system for referrals and authorizations.
- Maintains current referral forms and insurance resource materials.
- Monitors and reports productivity statistics data to supervisor on a weekly basis.
- Performs general clerical duties including, but not limited to, typing, filing, answering the telephone, monitoring incoming faxes/mail and assisting patients/providers at a service window or patient exam room.
- Performs other duties as assigned.
- Assists supervisor with special projects, as requested
- Must be able to adhere to the Attendance policy and procedure.
- Ability to collaborate, teach, support and function in a teaching organization that builds, coaches and embraces interns and residency programs. Must demonstrate a passion for the team and have the ability to consistently work with rotating doctors, residents and interns, while continuously building a trusting, safe, patient-centered workplace.
- Demonstrate the ability to be culturally sensitive and respect diversity, work effectively and with individuals of different cultures and socioeconomic status; Passion for service.
Education and Experience:
- Education: High school diploma or equivalent
- Experience: 3-5 years of customer service, or Referral experience in the medical field. Medical terminology required. As a requirement of this position you must receive EPIC certification for the module you have been hired into
- FQHC outpatient clinic
- Bilingual English/Spanish
Must be able to work in the U.S. legally. We are unable to sponsor H1B Visa’s.
SACHS is a part of National Health Service Corps for loan repayment assistance for certain positions.
Full Benefits Package; Vacation and Sick Leave Plans.
- Full Benefits Package; Vacation and Sick Leave Plans
- Medical / Dental / Vision packages.
- !! Monthly Premium Rates among the lowest in the industry!!
- Retirement Account with up to 8% employer contribution
- Employer-paid Life Insurance
- Fitness Facility access
- 8 Paid Holidays
- 1 Paid Birthday Holiday
Social Action Community Health System complies with applicable Federal and State civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation or gender identity.