Referral Coordinator Lead

3 days ago

Fresno, California, United States Clinica Sierra Vista Full time
Job Summary

Clinica Sierra Vista is seeking a highly skilled Referral Coordinator Lead to join our team. As a key member of our patient care team, you will be responsible for coordinating, processing, and scheduling specialty referrals for patients in Kern and Fresno County.

Key Responsibilities:

  • Coordinate and process specialty referrals, prior authorizations, and scheduling of medical services/procedures for patients as requested by primary care physicians.
  • Collaborate with medical providers, nursing staff, and other patient care support staff to ensure timely and efficient delivery of specialty services.
  • Provide training on Standard Work and promote performance improvement within the team.
  • Develop and implement innovative care models to improve quality outcomes and reduce unnecessary clinical variation.
  • Schedule, problem-solve, communicate, and coordinate referral appointments with outside specialists.
  • Track and enter all referral requests in the Referral Tracking System or EMR daily.
  • Coordinate with HIM staff to track the status of provider reports on patients referred to hospitals, outside clinics, and specialty providers.
  • Maintain accurate records of external referral patient appointments, including those kept, failed, and current status.
  • Evaluate specialty referrals based on medical necessity and managed care rules.
  • Produce accurate weekly reports of processed referrals to management.

Requirements:

  • Graduation from High School or equivalent GED.
  • Graduate of an accredited Medical Assistant program preferred, but not required.
  • Two to three years of medical back office or administrative medical experience in a community healthcare setting preferred but not required.
  • Bilingual in Spanish preferred but not required.
  • Previous experience with specialty referrals in community health desired.
  • Data analysis skills and knowledge of referral operations.
  • Computer proficiency in Excel, Word, Outlook, EPIC, PDF, etc.
  • Maintain excellent internal and external customer service at all times.
  • Maintain the highest degree of confidentiality possible when performing departmental functions.

About Clinica Sierra Vista:

Clinica Sierra Vista values human rights, goodwill, respect, inclusivity, equality, and recognizes that the organization derives its strength from a rich diversity of thoughts, ideas, and contributions. We aspire to be an employer of choice by promoting an organizational culture that reflects these core values.

We are an equal opportunity employer and strive to attract qualified applicants from all walks of life without regard to race, color, ethnicity, religion, national origin, age, sex, sexual orientation, gender identity, gender expression, marital status, ancestry, physical disability, mental disability, medical condition, genetic information, military and veteran status, or any other status protected under federal, state, and/or local law.

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