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Referral Coordinator

Company: TrueCare
Location: Oceanside
Posted on: September 18, 2022

Job Description:

TrueCare - $500 Sign On Bonus!Position Title: Referral Coordinator -Location: Oceanside Monday to Friday 8:00 am to 5:00 pm. (occasional Saturdays)TrueCare is more than just a place to work; it feels like home. Sound like a fit? We'd love to hear from you!Referral CoordinatorThe Referral Coordinator is responsible for the coordination, processing, obtaining prior authorizations, and requesting reports for a variety of medical referrals for services/procedures as requested by medical providers. The Referral Coordinator will also collaborate with other referral staff, medical providers, and patient care support staff to effectively communicate and ensure successful tracking and coordination of referrals.Essential Functions Monitors Electronic Health Record (EHR) tasks throughout the day to capture referral requests in real time.Gathers pertinent information as needed via EHR or from clinical team to accurately complete pre-authorization/referral process.Prepares and accurately processes referral and pre-authorization paperwork; ensures that referrals are addressed in a timely manner, prioritizing urgent items appropriately.Verifies insurance information and performs eligibility checks by telephone or electronically, as appropriate, for referral purposes.Produces and submits all appropriate notification letters for patients and clinicians, as required.Ensure complete tracking and follow-up on all referral requests and specialty report requests.Answers, responds and documents phone calls, requests and questions from patients in a timely manner; reviews details and expectations about referrals with patients.Responds to clinical support staff questions, requests and concerns regarding the status of patient referrals, care coordination or follow-up status.Utilizes third party payer/insurance portals as needed. Ensures proper use of Current Procedural Terminology (CPT) and current International Classification of Diseases (ICD) codes to meet the requirements of third party payers and specialty clinics to ensure minimal delay in securing referral appointments or pre-authorizations. Follow-up with clinicians as needed. Responsible for proper documentation according to TrueCare protocols.Utilizes EHR functions and/or other software systems to document all pertinent referral or Patient Health Information (PHI).Schedules referral appointments directly on behalf of patients, as needed.Tracks referrals utilizing the EHR or other established system.Properly follow-up with provider and patient regarding denials to referral requests.Cross trains with other Referral Coordinators to learn each process related to the various service lines provided by TrueCare completely to ensure coverage is available.Maintains confidentiality of PHI by following all applicable Health Insurance Portability and Accountability Act (HIPAA) regulations. Job RequirementsHigh school diploma or equivalent.At least one year of experience as a Medical Receptionist or Medical Assistant (MA) in an outpatient setting, or in medical case management.Knowledge of medical terminology and procedures, and CPT and ICD codes.Availability to work outside of normal shifts (i.e., 8am to 5pm and on Saturdays).Computer literacy working with PC-based software applications and proficiency with the Microsoft Office suite, including Outlook, Word and Excel. Nice to HaveBilingual in English and Spanish.Two years of referral coordination or medical assisting experience.Understanding of insurance providers, their portals and their expectations for authorization approvals.Medical Assistant certification.Experience working in a community health center.Working knowledge of EHR and registration/billing software.Licenses May be required to travel between all TrueCare's sites and locations therefore California Driver's License, proof of insurance and clean driving record required.TrueCare requires employees to be vaccinated as a condition of employment, subject to accommodation obligations. " The State of California released a new order requiring all staff in healthcare settings to be fully boostered by March 1, 2022. At Truecare, we put your health first. Our compassionate team understands your needs and provides a heartfelt welcome to each and every person who walks through our doors.Visit truecare.org to learn more! Health Inside. Welcome in! Salud Adentro. Bienvenido!TrueCare is committed to a policy of Equal Employment Opportunity and will not discriminate against an applicant or employee on the basis of race, color, religion, creed, national origin, ancestry, sex, gender, age, physical or mental disability, veteran or military status, genetic information, sexual orientation, gender identity, gender expression, marital status, or any other characteristic protected by applicable federal, state, or local law. PI191804864

Keywords: TrueCare, Oceanside , Referral Coordinator, Other , Oceanside, California

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