Managed Care Referral Specialist I

Family Health Centers of San Diego; San Diego (CA); Presencial; USD 34 000 - 43 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Salary commensurate with experience

Onsite locations across San Diego

Retirement Plan with Employer Match

Paid Time Off

Resumo da oferta

Family Health Centers of San Diego is seeking a Referral Specialist to manage referrals and pre-authorization tasks across multiple sites in San Diego. The role requires careful documentation, timely communications with clinics, and adherence to insurance requirements.

The ideal candidate will have at least 1 year in ambulatory care, a high school diploma or GED, and a Medical Terminology course or the ability to complete it within 90 days.

Qualificações

• At least 1 year of experience in ambulatory care setting or similar setting is strongly preferred.
• High school diploma or GED equivalent required.
• Medical Terminology Course required, or able to complete within 90 days of hire.
• Bilingual English/Spanish is required.
• Traveling between sites and other locations is occasionally required.

Responsabilidades

• Completes all required documentation accurately, in a timely manner, and thoroughly in accordance with department standards; documentation complies with patients' insurance requirements.
• Meets daily referral modification productivity standards for Referral Specialists, adhering to referral processes and guidelines.
• Per referral guidelines, provide appropriate clinical information to specialist.
• Prepares and processes all referral and pre-authorization paperwork, including gathering pertinent information as needed via EHR, from incoming phone/email/fax messages, or from clinical team.

Conhecimentos

Bilingual English/Spanish

Formação académica

High school diploma or GED

Medical Terminology Course

Descrição da oferta de emprego

For more than 55 years, Family Health Centers of San Diego's (FHCSD) mission has been to provide caring, affordable, high-quality health care and supportive services to everyone, with a special commitment to uninsured, low-income and medically underserved persons. FHCSD is one of the top 10 largest federally qualified health centers (FQHCs) in the country. We operate more than 90 sites across San Diego County, including 29 primary care clinics, 23 behavioral health facilities, 10 physical rehabilitation clinics, nine dental clinics, five vision clinics, four outpatient substance use treatment programs, three mobile medical units, two mobile counseling centers, two urgent care centers, and a pharmacy.

Our staff provides care to over 227,000 patients each year, of whom 91% are low-income and 29% are uninsured. FHCSD provides care to all.

Services include, but are not limited to adult care, chronic disease management, pediatrics, comprehensive women's care including obstetrics, dental, vision, case management, physical rehabilitation, speech therapy for children, vaccinations, infectious diseases, behavioral health, substance use counseling and a host of specialty services including cardiology, podiatry, endocrinology, dermatology, among others.

FHCSD also offers supportive services to those who are unsheltered and in need of intensive case management.

The breadth of our clinic locations, services and programs has grown over the last five decades, making us the largest community clinic provider of health care to the uninsured in the county and one of the top 10 largest community clinic organizations in the nation.

We are also the largest health care safety-net provider, largest school-based health care provider and the largest mental health provider in the San Diego region.

Responsibilities:

• Completes all required documentation accurately, in a timely manner, and thoroughly in accordance with department standards; in addition, documentation complies with patients' insurance requirements.
• Meets daily referral modification productivity standards for Referral Specialists, adhering to referral processes and guidelines.
• Per referral guidelines, provide appropriate clinical information to specialist.
• Performs other duties as assigned.
• Prepares and processes all referral and pre-authorization paperwork, including gatherings pertinent information as needed via EHR, from incoming phone/email/fax messages, or from clinical team.
• Contacts various clinics, facilities, and companies to obtain information to accurately complete referral/pre-authorization requests.

Requirements:

• At least 1 year of experience in ambulatory care setting or similar setting is strongly preferred.
• High school diploma or GED equivalent required.
• Medical Terminology Course required, or able to complete within 90 days of hire.
• Bilingual English/Spanish is required.
• Traveling between sites and other locations is occasionally required.
• Must have a valid California driver's license, an automobile, and proof of minimum levels of car insurance as required under California law, although limits of $100,000 are recommended.
• An acceptable driving record is also required.
• California law requires all drivers to obtain a valid California driver's license within ten days of establishing residency.
• Reasonable accommodation may be provided on a case-by-case basis.
• Mileage and other reimbursement governed by policy.

Rewards:

• Job type: Regular Full-time, M-F 8am-5pm.
• Onsite: 5160 Federal Boulevard San Diego, CA 92105
• 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
• The successful candidate will have a demonstrated commitment to community medicine and providing culturally competent care to the medically underserved.
• We are excited to share that the salary range for this position is: $25.00 - $30.93
• Information on our extensive benefits package can be found here: FHCSD Wellness - Employee Hub (gobenefits.net)
• FHCSD provides Equal Employment Opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.
• This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, transfer, leave of absence, compensation, and training.

About Us

Founded in 1970, Family Health Centers of San Diego is dedicated to providing caring, affordable, high-quality health care and support services to all people, with a special commitment to the uninsured, low-income and medically underserved. We are the largest community clinic provider of health care to the uninsured in Southern California and one of the top 10 largest community clinic organizations in the country.

Anti-Discrimination Statement

Family Health Centers of San Diego complies with applicable Federal civil rights laws and does not discriminate, exclude people or treat them differently on the basis of race, color, national origin, religion, physical and mental disability, sex, including pregnancy, childbirth and related medical conditions, age, genetic information, language preference/ability, citizenship status, marital status, sexual orientation and gender identity, AIDS/HIV, medical condition, political activities or affiliations, military or veteran status, or status as a victim of domestic violence, assault, or stalking.