Referral Coordinator I-II - Surgical Subspecialty Clinic

Referral Coordinator I/II – Surgical Subspecialty This position is an integral part of the care team, supporting multiple surgical subspecialties, including otolaryngology (ENT), urology, neurosurgery, and plastic surgery. The Referral Coordinator is a liaison between the patient, providers (both internal and external), health plans, and various departments to ensure timely access to specialty care and diagnostic services. Salary Referral Coordinator I: $24.31 – $34.04 per hour Referral Coordinator II: $25.53 – $35.74 per hour Distinguishing Characteristics This classification emphasizes coordination of care rather than clerical front‑office duties. It differs from the Medical Assistant classification series, which is more clinically focused. Level I and Level II differ in the complexity of the work performed. Incentives Educational incentive of 2.5%, 3.5%, or 5% based on completion of an Associate’s, Bachelor’s, or Master’s degree that is not required for this classification. Bilingual incentive may be awarded based on operational need and certification of skill. Department / Agency Health Care Agency – Ambulatory Care, Surgical Clinics. This SEIU classification is eligible for overtime compensation. Vacancies There are currently three vacancies located within Ambulatory Care’s Surgical Clinics. Responsibilities Initiate and complete the life cycle of the referral. Initiate and complete the pre‑authorization process. Communicate with insurance companies, physicians, and patients regarding referral status. Coordinate surgical referral appointments, answer phone calls, and monitor EHR reports and incoming faxes for errors and activities. Document and update specialty referral status on EHR and/or referral module as appropriate. Complete a modified referral/RAF/follow‑up assignment daily. Promote efficient continuity of patient care through participation in quality improvement projects. Adhere to and observe all safety policies and procedures, including infection control rules and regulations. Demonstrate cultural sensitivity and competence with patients. Maintain and adhere to HIPAA, employee confidentiality, and privileged communications. Submit timely and accurate referrals into appropriate portals. Assist with coordination of care, including scheduling of specialty appointments and schedule management activities to optimize access. Ensure that each surgical referral has all necessary documentation (e.g., doctor’s notes, authorizations, and any necessary tests) prior to submitting for approval or external referral. Follow up with specialist office to request notes and close the loop after appointment. Collaborate with Medical Management, utilization management, and health plans to resolve issues with pending authorizations. Collaborate with contracting team to resolve issues related to patient referrals or specialty providers. Perform troubleshooting when problems arise; take independent action to resolve complex issues. Provide support to providers with referral submission and modifications. Support clinical staff with questions and redirects in conjunction with utilization management and medical management. May support clinic teams with referrals, acting as a subject‑matter expert. Perform additional duties as assigned. Level II Additional Responsibilities Support surgery scheduling for all specialties. Collaborate with medical staff to coordinate post‑operative appointments. Provide support with preparing and updating referral reports. Provide training, including development of written standard work. Education, Training, and Experience Level I: Three (3) years of experience working in a clinic setting, including one (1) year performing duties related to the surgical referral process (authorizations and eligibility). Level II: Three (3) years of experience performing duties similar to those of a Referral Coordinator I in a surgical clinic setting. Special Requirements Valid Basic Life Support (BLS/CPR) certificate at time of employment and maintenance thereafter. Desired Qualifications Medical Assistant certificate. Bilingual proficiency in English/Spanish. Knowledge, Skills, and Abilities Thorough knowledge of medical terminology, health plans, electronic health records, procedural and diagnostic coding. Skill in operating a computer, e‑fax, photocopy machine, Outlook, Word, Excel, and One‑Note. Ability to read, understand, and follow oral and written instructions; communicate effectively verbally and in writing; establish and maintain effective relationships with patients, employees, and the public; provide excellent customer service; analyze data and workflows; resourcefully problem‑solve; manage conflict and competing priorities; process surgical medical referrals. Work Environment Work is performed in an indoor health care delivery environment with frequent contact with patients and the public. Equal Employment Opportunity The County of Ventura is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding, and related medical conditions), and sexual orientation. #J-18808-Ljbffr