Referral Coordinator

4 months ago

Ontario, United States Unicare Community Health Center Full time
Job DescriptionJob Description

At Unicare, we strive to provide high quality health care to the community we serve. Our goal is to provide easily accessible, comprehensive, and affordable health care to every family member, while reducing visits to emergency rooms and urgent care facilities. Our mission is to be a community health care organization that treats everyone with dignity, respect and cultural sensitivity to help create an environment in which all can prosper.

Unicare is currently seeking a Full-Time bilingual Spanish Referral Coordinator with a minimum of two years’ experience in family practice setting.

Referral Coordinator is responsible for coordinating the care between the medical providers and the specialists to ensure that the patients are getting the appropriate care. The referral coordinator coordinates, processes and documents medical referrals and prior authorizations for a variety of medical services for clinic patients, as requested by clinic providers.

Qualifications, Education & Experience:

  • Excellent people skills, with an ability to partner with a dynamic leadership team
  • Possess personal qualities of integrity, credibility, and commitment to corporate mission
  • Flexible and able to multitask; can work within an ambiguous, fast-moving environment, while also driving toward clarity and solutions; demonstrated resourcefulness in setting priorities

Essential Duties and Responsibilities:

  • Responsible for processing the referrals submitted by health care providers in all referral queues
  • Must complete the referral life cycle, submit-approve-notify patient follow up secure medical records within the identified time periods
  • Adhere to insurance requirements and closely communicate with clinicians for all clinical care needs to profess a referral
  • Maintain ongoing tracking and appropriate documentation on referrals to promote team awareness and ensure patient safety
  • This tracking may use an EHR database
  • Ensure complete and accurate registration, including patient demographics and current insurance information
  • Assemble information concerning patient’s clinical background and referral needs. Per referral guidelines, provide appropriate clinical information to specialist
  • Contact review organizations and insurance companies to ensure prior approval requirements are met. Present necessary medical information such as history, diagnosis and prognosis. Provide specific medical information to financial services to maximize reimbursement to the clinic, hospital and physicians
  • Review details and expectations about the referral with patients
  • Assist patients in problem solving potential issues related to the health care system, financial or social barriers (e.g., request interpreters as appropriate, transportation services or prescription assistance)
  • Be the system navigator and point of contact for patients, families, with patients and families having direct access for asking questions and raising concerns. May assume advocate role on the patient’s behalf with the carrier to ensure approval of the necessary supplies/services for the patient in a timely fashion
  • Identify and utilize cultural and community resources. Establish and maintain relationships with identified service providers
  • Ensure that referrals are addressed in a timely manner
  • Remind patients of scheduled appointments via mail, email or phone
  • Ensure that patient’s primary care chart is up to date with information on specialist consults, hospitalizations, ER visits and community organization related to their health

Currently, the Company offers the following benefits:

  • 100% medical, dental, and vision coverage for employee
  • $50,000 life insurance
  • 403(b) up to 4% match

During the first 12-month periods of employment you will accrue benefits as follows:

  • Five (5) days of Vacation, use subject to a 6-month waiting period
  • Six (6) days of Sick, use subject to a 90-day waiting period.
  • Nine (9) Paid Holidays, as applicable after 90 days of employment

How to Apply:
If you would like to learn more about this great opportunity, please submit a cover letter and your resume. We look forward to hearing from you

WORK HOURS:
Monday-Friday, 9am to 6pm, part or all of an 8-hour shift. Occasional Saturday shift may be required. May travel to other Unicare Health Centers as needed

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