Referral Associate
2 weeks ago
Located in one of the most beautiful regions in the United States, St. Helena Hospital was founded in 1878 and has a rich history of innovative medical care. We are comprised of a 151-bed hospital, emergency department and medical offices with centers of excellence in specialty care, including Adventist Heart and Vascular Institute, Coon Joint Replacement Institute, Martin-O'Neil Cancer Center and Behavioral Health units. In the heart of Napa Valley, St. Helena is a charming place, and the quality of life is unsurpassed with outdoor adventure, rejuvenation at luxurious spas, popular restaurants, as well as perfect weekend getaways to San Francisco or the coast.
Job Summary:
Coordinates and completes referrals 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, including, but not limited to, measles, mumps, flu (based on the seasonal availability of the flu vaccine typically during October-March each year), COVID-19 vaccine (required in CA, HI and OR) etc., as a condition of employment, and annually thereafter. Medical and religious exemptions may apply.
About Us
Adventist Health is a faith-based, nonprofit, integrated health system serving more than 90 communities on the West Coast and Hawaii with over 400 sites of care, including 26 acute care facilities, clinics, home care, and hospice agencies in both rural and urban communities. Our compassionate and talented team of 37,000 includes employees, physicians and volunteers driven in pursuit of one mission: living God's love by inspiring health, wholeness and hope.
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