Medical Referral Clerk

Job Description Position Summary: Under the direction of the Referral Supervisor, the position assists patients with referral needs and to connect patient services with outside resources. Essential Duties and Responsibilities: Process referrals for insured and uninsured patients throughout Los Angeles County utilizing Medpoint System for insured patients and the Referral Processing System (RPS) and eConsult for uninsured patients. And uninsured patients for mammography will be referred to in-house service provided by outside agency. Process referrals with private insurances HMO and PPO. Verify patient insurance status whether patient have insurance or not. If patient is insured, check eligibility to determine specialist’s resource. If patient is uninsured, chose public resource. Refer for in-house service such as retinal screening and telederm for uninsured patient. Communicate daily with Health Care LA IPA, RPS system and eCounsult to check status. Upon approval for referral request, notice to patient appropriately such as phone and mail. And send necessary document to specialist by fax. Request report from specialists and the report will be scanned into eCW and assigned to appropriate physician. For mammogram and retinal screening, patient will be referred to specialist for necessary treatment according to the report. Each referral clerk documents all the process in ecw until we receive the report. And record necessary information to keep track on referral status on our own. Attend monthly meetings addressing utilization management for Health Care LA IPA , eConsult and RPS system. (for designated staff only) Responsible for a monthly report to measure productivity. Other duties as assigned. Qualifications and Experience Requirements: 1-2 years processing referrals and prior authorizations preferred 1-2 years experience in a community clinic preferred. Knowledge in Medical Terminology Ability to work with people of diverse cultural, educational, social, and economic backgrounds Excellent oral and written communication skills Excellent organizational skills Computer proficiency Experience utilizing an Electronic Medical Records (EMR) system is highly desirable High School Diploma or equivalent Bilingual required Company Description T.H.E. Health and Wellness Centers is a nonprofit community clinic in South Los Angeles. For more than 50 years, we've provided high-quality, low cost healthcare and preventative education for all. We are an Equal Opportunity Employer. Company Description T.H.E. Health and Wellness Centers is a nonprofit community clinic in South Los Angeles. For more than 50 years, we've provided high-quality, low cost healthcare and preventative education for all. We are an Equal Opportunity Employer. #J-18808-Ljbffr To Help Everyone Health & Wellness Centers