Referral Associate (Outpatient)

Job Description

Adventist Health Sonora has been one of the area's leading healthcare providers since 1900. We are comprised of a 72-bed hospital, 30 medical offices, comprehensive cancer care and a vast scope of award-winning services located throughout Tuolumne and Calaveras counties and the surrounding areas. Sonora is known for its friendly hometown charm, vast outdoor experiences and lively downtown. The allure of Sonora's close-knit community is complimented by its proximity to Yosemite National Park, as well as just a quick drive to Lake Tahoe.

Job Summary:

Coordinates and completes referrals within the Hospital-based Outpatient Clinics (HBOC) including acquiring and verifying third party information, obtaining and arranging appointments and tracking. Works on routine assignments within defined parameters, established guidelines and precedents. Follows established procedures and receives daily instructions on work.

Job Requirements:

Education and Work Experience:

• High School Education/GED or equivalent: Preferred
• Associate's/Technical Degree or equivalent combination of education/related experience: Preferred

Licenses/Certifications:

• Certified Nurse's Assistant (CNA), Medical Assistant (MA), or medical terminology course: Preferred

Essential Functions:

• Communicates with ordering providers and nursing regarding insurance authorizations, denials, peer-to-peer review requests and scheduling difficulties with referrals to providers.
• Takes telephone requests for authorizations. Prepares referral requests. Informs patients of appointment information and instructions.
• Maintains electronic health record (EHR) referral documentation to reflect actions on specific referrals (including adding incoming referrals that were not generated from the electronic health record (HER)). Maintains referral resource document.
• Schedules referral appointments with appropriate department or referred to provider. Tracks referral patient compliance and communicate with referring provider as necessary regarding patients refusing service and patients not showing up to a referral appointment.
• Submits retroactive authorization requests as needed.
• Performs other job-related duties as assigned.

Organizational Requirements:

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply. Adventist Health participates in E-Verify. Visit for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.