Referral Coordinator

Job Description

Job Description

Company Mission Statement:
The Mission of JWCH Institute is to improve the health status and well-being of under-served segments of the population of Los Angeles Area through the direct provision or coordination of health care, health education, services, and research.

Position Purpose:

Under the supervision of the Program Manager, the Referral Coordinator is primarily responsible for coordinating and maintaining the health care center’s referral system, managing the referral process for patients requiring specialized medical services. The Referral Coordinator also serves as a liaison between the clinic, medical facilities, and other social service agencies to coordinate health services for JWCH's patients.

Principal Responsibilities:

1. Process incoming and outgoing referrals accurately and efficiently within the standards of care timelines:
   • Urgent – 24 hours
   • Routine – up to 5 business days
2. Ensure all necessary documentation and medical records accompany each referral, including:
   • Hospital notes, imaging, laboratory results
3. Ensure all assigned referrals are processed in a timely and accurate manner.
4. Regularly log into IPA portals (e.g., HCLA, CFC, HDMG, LA Care Direct).
5. Log into the referral database and Next-Gen daily.
6. Add appropriate service codes and assist patients in finding specialists as recommended by their PCP.
7. Act as the primary liaison between patients, referring physicians, and specialists.
8. Provide patients with information regarding referral procedures and appointments.
9. Contact the respective IPA to ensure patients' needs are met.
10. Verify insurance coverage and obtain pre-authorizations for specialist visits.
11. Communicate with insurance companies to resolve any issues related to referrals.
12. Maintain accurate and organized records of all referrals and communications.
13. Track referral outcomes and follow up with patients regarding their care.
14. Assist patients with questions or concerns about the referral process or specialist visits.
15. Ensure adherence to relevant regulations and organizational policies.
16. Participate in quality improvement initiatives related to referral processes.
17. Review all referrals weekly and monthly to ensure processing standards are met.
18. Schedule appointments and verify that patients receive the care requested by their primary care provider.
19. Notify the primary care provider if a patient does not follow through with a referral appointment.
20. Maintain an environment conducive to patient comfort and confidentiality.
21. Assist other clerical staff in clearing charts and answering phones.
22. Provide information and respond to patient inquiries in person, by mail, and by phone.
23. Perform other clerical tasks as assigned.

Requirements:

1. Medical training or experience preferred (i.e. Medical Assistant Certification)
2. Proven experience working in a healthcare setting, preferably in a role involving patient referrals or coordination.
3. Proficiency in using electronic medical records (EMR) systems and other relevant software applications.
4. Strong organizational skills with the ability to prioritize tasks and manage time effectively.
5. Excellent communication and interpersonal skills, with the ability to interact professionally with healthcare providers, patients, and team members.
6. Attention to detail and accuracy in data entry and record-keeping.
7. Knowledge of medical terminology, insurance procedures, and referral processes.
8. Ability to maintain patient confidentiality and adhere to HIPAA regulations.
9. Adaptability and flexibility to handle changing priorities and work independently or as part of a team.
10. Strong computer skills including MS Word and Excel.
11. Able to work with people from diverse ethnic, cultural, and socioeconomic backgrounds.
12. Bilingual English/Spanish preferred.

*All JWCH, Wesley Health Centers workforce members are recommended to be fully vaccinated and boosted against COVID-19.

Employee Benefits:

At JWCH Institute, Inc., we believe in taking care of those who take care of others. If you work 30+ hours per week, you’ll enjoy competitive pay and a robust benefits package that includes:

• Medical, Dental, Vision
• Monthly employer-sponsored allowance for assistance with health premiums.
• Funded Health Savings Account (up to deductible) to assist with carrier-approved medical expenses.
• Paid time off (vacation, sick leave) and 13 paid holidays.
• 401(k) Safe Harbor Profit Sharing plan.
• Mileage reimbursement.
• Short- and long-term disability plans (LTD/STD).
• Life insurance policy & AD&D, and more!

Become part of a team where your work matters. Apply today and help us change lives, one patient at a time.

JWCH Institute, Inc + Wesley Health Centers is an Equal Opportunity and Fair Chance Employer.