Specialty Referral Coordinator (Temporary to hire)

Job Description

Job Description

Description:

Job Title:  Specialty Referral Coordinator (Temporary to hire)

Pay:      $23 - $26 hourly

Location: Tustin, CA

Opening: 1

Position Purpose: Under the supervision of the Authorization Supervisor. The Specialty Referral Coordinator holds a pivotal role in overseeing the efficient management of referral submissions and subsequent follow-ups across various insurance payers, encompassing Medicare, Medi-Cal, HMOs, PPOs, and our uninsured patient population. This position is dedicated to ensuring the timely resolution of all assigned referrals, adhering rigorously to internal protocols and contractual health plan requirements.

Core Duties and responsibilities, include but are not limited to:

1. Process incoming referral requests from healthcare providers and ensure accurate documentation and completion
2. Verify patient insurance information and eligibility for referral services
3. Coordinate with healthcare providers and insurance companies to obtain necessary authorizations for referrals
4. Communicate with patients regarding referral appointments, instructions, and any required pre-authorization paperwork
5. Maintain detailed records of all referral requests, authorizations, and follow-up communications
6. Collaborate with internal departments to schedule referral appointments and coordinate care for patients
7. Assist patients with any questions or concerns regarding their referral process or appointments.
8. Monitor referral status and follow up on any pending or incomplete authorizations
9. Ensure compliance with organizational policies, procedures, and regulatory requirements related to referral processes
10. Provide support and assistance to referral team members as needed
11. Participate in training sessions to stay updated on changes in referral processes and procedures
12. Maintain confidentiality of patient information in accordance with HIPAA regulations
13. Collaborate with other healthcare professionals to facilitate the referral process and ensure seamless patient care
14. Assist with other administrative tasks and projects as assigned by supervisor or manager
15. Act as a liaison between patients, healthcare providers, and insurance companies to facilitate smooth referral processes
16. Communicate effectively with internal and external stakeholders to resolve any issues or concerns related to referrals
17. Prioritize tasks and manage workload effectively to meet deadlines and ensure timely completion of referral requests
18. Continuously seek opportunities for process improvement and efficiency in referral workflows
19. Provide excellent customer service to patients and stakeholders throughout the referral process
20. Attend meetings and training sessions as required to stay informed about changes in referral policies and procedures

This job description in no way states or implies that these are the only duties to be performed by the employee. He or she will be required to follow any other instructions and to perform other duties, within scope, as assigned by his or her supervisor.

Education, Qualifications, and Experience:

• High School Diploma or equivalent (GED) required
• Minimum 2 years of related experience
• Bilingual: Spanish required
• Must excel in multitasking within a high-paced environment
• Strong computer skills, acute attention to detail, confident and professional communication, and responsiveness to the needs of both internal and external customers in a personable manner are expected
• Knowledgeable in general EMR/EHR systems is preferred
• Experience in a medical setting is preferred

Work Schedule:

• FTOC is an in-person organization first, and foremost. Employees are expected to be on-site for their scheduled shifts.
• Hours of operation are Monday to Friday 8 a.m. to 8 p.m., however, employee schedules vary, depending on organizational, staffing, community, and patient needs. As such, FTOC may need to modify work schedules to meet such needs.
• Holidays and weekends may be required depending on an employee’s department due to organizational, staffing, community, and patient needs as FTOC continues to grow and expand work days and hours.
• Overtime may also occur due to organizational, staffing, community, and patient needs.

Families Together of Orange County (FTOC) is proud to be an equal opportunity employer. FTOC does not discriminate based on race, color, creed, sex, sexual orientation, gender identity or expression, age, religion, national origin, disability, ancestry, marital status, veteran status, medical condition, or any protected category prohibited by local, state or federal laws.