PDS Referral Specialist
1 month ago
Family Health Centers of San Diego (FHCSD) is passionate about providing exceptional health care to all, especially underserved communities with limited health care options. Founded by a Latina grandmother/community advocate over 50 years ago in Barrio Logan, FHCSD has grown into one of the largest community health systems in the country. With over 62 sites, over 227,000 patients, and over 417,000 visits last year, we provide a wide variety of health care and outreach services to a very diverse patient population. We are proud of our mission, our lasting community impact, and the cultural and individual diversity of our staff.
Family Health Centers of San Diego is looking for a PDS Referral Specialist who is responsible for completing all required documentation in assisting with medical referrals that has increased in volume due to the significant impact of the COVID-19 pandemic on the residents that FHCSD provides healthcare-related services.
Responsibilities:
Complete all required documentation in assisting with medical referrals that has increased in volume due to the significant impact of the COVID-19 pandemic on the residents that FHCSD provides healthcare-related services.
Coordinate, process, and document medical referrals and prior authorizations that has increased in volume due to the significant impact of the COVID-19 pandemic on the residents that FHCSD provides healthcare-related services.
Complete all required documentation accurately, in a timely manner, and thoroughly in accordance with department standards, and ensure required documentation complies with patients' insurance requirements.
Meet established daily referral modification productivity standards, adhering to referral processes and guidelines, and follow referral guidelines in providing appropriate clinical information.
Prepare and process all referral and pre-authorization paperwork to include information as needed via EHR, incoming phone/email/fax messages, or from clinical team.
Time will be dedicated to the increased demand of processing and uploading consult notes and order requests from external specialists due to the significant impact of the COVID-19 pandemic on the residents that FHCSD provides healthcare-related services.
Contact various clinics, facilities, and companies to obtain information to accurately complete referral/pre-authorization requests.
Grant funded program. This position is funded through 03/31/2023; continuation of employment is dependent upon availability of and/or renewed funding.
Perform other duties as assigned.
Requirements:
At least 1 year of experience in ambulatory care setting or similar setting is strongly preferred.
High school diploma or GED equivalent required.
Or equivalent combination of education and experience that provide the skills, knowledge and ability to perform the essential job duties, and which meets any required state or federal certification requirements.
Medical Terminology Course required, or able to complete within 90 days of hire.
Clinical knowledge of medical terminology, medical procedures, CPT, and ICD-9 (10).
Intermediate knowledge of insurance providers, their portals and their expectations for authorization approval.
Bilingual English/Spanish is required.
Rewards:
Job type: Regular Full Time
Competitive Salary with Excellent Benefits
Retirement Plan with Employer Match
Paid Time Off, Extended Sick Leave and Paid Holidays
Medical/Dental/Vision/FSA/Life Insurance
Employee Discounts and Wellness Programs
#IndPDS
The successful candidate will have a demonstrated commitment to community medicine and providing culturally competent care to the medically underserved.
In the spirit of pay transparency, we are excited to share the base range for this position, exclusive of fringe benefits or potential bonuses.
$21.00 - $22.67
If you are hired at Family Health Centers of San Diego, your final base salary compensation will be determined based on factors such as geographic location, jurisdictional requirements, skills, education, and/or experience. In addition to these factors – we believe in the importance of pay equity and consider internal equity of our current team members as a part of any final offer. Please keep in mind that the range mentioned above is what we reasonably expect to pay for the role. Hiring at the maximum of the range would not be typical in order to allow for future and continued salary growth. We also offer a generous compensation and benefits package (more information on our benefits offerings is available here: FHCSD Wellness – Employee Hub (gobenefits.net)
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