PACE Referrals Specialist

Ignite Human Capital LLC; Riverside (CA); On-site; USD 52,000 - 68,000; Full time

Job summary

Ignite Human Capital LLC in Riverside, CA is seeking a Referrals Specialist to coordinate all referrals and follow-up care for PACE participants. The role handles receiving, processing, scheduling, and following up on referrals for diagnostic testing, medical specialists, and other providers.

It is a full-time, onsite position based in Riverside. The Referrals Specialist will serve as the main contact for providers, schedule appointments, arrange transportation, and manage EMR updates to ensure

Qualifications

• Experience coordinating referrals and follow-up care.
• Strong communication with providers, clinics, and families.
• Experience using EMR systems for referrals and scheduling.

Responsibilities

• Serve as the main point of contact for providers and clinic staff on referrals, authorizations, and appointment scheduling
• Prepare, process, and complete referrals accurately and on time, including urgent and stat referrals
• Arrange transportation for participants to internal and external medical appointments, including escort coordination
• Communicate referral details and appointment instructions to participants and their families
• Track referrals in designated logs and in the electronic medical record (EMR)
• Follow up on submitted authorization requests, maintain status updates in the EMR, and escalate issues until the referral loop is closed
• Complete surgery scheduling with proper CPT codes and all follow-ups, including pre/post orders, labs, PAs, and imaging
• Manage re-authorizations across all payors, working with clinical teams to prevent lapses or delays in care
• Review consultation reports for needed follow-up and work with providers to process them promptly

Job description

PACE Referrals Specialist

Full-Time | Onsite | Riverside, CA

About the Organization

We are working with a private, nonprofit 501(c)(3) community health organization delivering over 500,000 medical, dental, and behavioral health visits to more than 100,000 people each year. Our PACE (Program of All-Inclusive Care for the Elderly) program is a managed medical plan that surrounds participants with a team of physicians, nurses, social workers, therapists, and care coordinators. Our goal is to help seniors stay healthy and happy at home, surrounded by family and community. With two PACE centers in Riverside County, the program is positioned to serve over 650 senior participants.

Role Overview

The Referrals Specialist coordinates all referrals and follow-up care for PACE participants. This includes receiving, processing, scheduling, and following up on all medical referral requests, both in-house and outside, for diagnostic testing, medical specialists, and other providers.

Schedule & Location

• Hours: Monday–Friday, 8:00am–4:30pm
• Riverside, CA. This position is fully onsite.

Responsibilities

Participant Care Coordination

• Serve as the main point of contact for providers and clinic staff on referrals, authorizations, and appointment scheduling
• Prepare, process, and complete referrals accurately and on time, including urgent and stat referrals
• Arrange transportation for participants to internal and external medical appointments, including escort coordination
• Communicate referral details and appointment instructions to participants and their families
• Track referrals in designated logs and in the electronic medical record (EMR)
• Follow up on submitted authorization requests, maintain status updates in the EMR, and upscale issues until the referral loop is closed
• Complete surgery scheduling with proper CPT codes and all follow-ups, including pre/post orders, labs, PAs, and imaging
• Manage re-authorizations across all payors, working with clinical teams to prevent lapses or delays in care
• Review consultation reports for needed follow-up and work with providers to process them promptly