Bilingual Medical Referral Coordinator

El Proyecto Del Barrio; Los Angeles (CA); On-site; USD 30,000 - 37,000; Full time

Job summary

El Proyecto Del Barrio is seeking a Referral Coordinator at the Winnetka Health Clinic in Winnetka, CA. This full-time role will coordinate patient referrals, process HMOs, Medi-Cal, Medicare, and MHLA referrals, and ensure timely submission of required reports.

The ideal candidate has a high school diploma, 1–2 years of related experience, strong organizational skills, and proficiency with Microsoft Office.

Qualifications

• Knowledge of medical referral processes and procedures.
• Knowledge of CPT codes and ICD10.
• High level of professionalism, customer service, and interpersonal skills.
• Ability to be well-organized and precise.
• Strong computer skills in Microsoft Office.
• Ability to communicate in an articulate, professional manner while maintaining confidentiality.
• Ability to work independently, meet deadlines, and multi-task while maintaining quality standards.

Responsibilities

• Process referral requests, verifying insurance eligibility.
• Obtain necessary authorizations and enter data to generate authorization numbers.
• Present prospective and retrospective referrals to the UR meeting.
• Maintain logs to track prospective, retrospective, and denials.
• Submit required UM reports to the health plans in a timely fashion.
• Coordinate with the Claims Adjudicator and Case Managers about referrals, claims, and case management.
• Liaise among patients, Managed Care Department, providers, specialists, hospitals, and health plans on referrals.
• Assist providers and specialists with the referral process.
• Perform other duties as assigned.

Skills

Medical referrals

CPT/ICD10 knowledge

Organized

Customer service

Microsoft Office

Confidentiality

Independent work

Multitasking

Communication skills

Education

High school diploma or equivalent

1–2 years related experience

Job description

El Proyecto Del Barrio is seeking a Referral Coordinator at the Winnetka Health Clinic in Winnetka, CA. This full-time role will coordinate patient referrals, process HMOs, Medi-Cal, Medicare, and MHLA referrals, and ensure timely submission of required reports.

The ideal candidate has a high school diploma, 1–2 years of related experience, strong organizational skills, and proficiency with Microsoft Office.