Referral Care Navigator: Streamline Patient Access

DAP Health; Cathedral City (CA); On-site; USD 30,000 - 33,000; Full time

Job summary

DAP Health is seeking a Referral Care Coordinator to ensure continuity of care for patients with referral orders and coordinate timely specialty or ancillary appointments. You will document referrals in the patient’s chart or EHR and perform data entry in the i2i system.

Responsibilities include processing referrals, obtaining authorizations, coordinating with PCPs, insurers, and patients to overcome delays in care, and maintaining accurate referral records.

Qualifications

• Diploma from an approved High School or GED Equivalent.
• One year of medical field experience with an understanding of insurance and medical terminology is required.
• CPR and First Aid certification is required for all staff.

Responsibilities

• Process referrals according to the level of urgency.
• Data entry of all new referrals into the i2i referral module; documentation of all interventions to include, date and time.
• Documents necessary information pertaining to the referral order in the patient’s chart or EHR.
• Submits authorization to insurances, tracks the status of the authorization; once approved, documents procedure approval number and authorization period in the referral tracking system.
• Coordinates between patient and specialty provider to schedule appointments; provides special instructions if needed.
• Communicates with primary care provider to inform of any delays or barriers to care.
• Communicate with patients if there are any delays in scheduling appointments.
• Monitor’s patient compliance and re-schedules appointments as needed.
• Responsible for tracking reports and making sure that all reports are received in a timely manner; close referrals once the report is received.
• Works with the Primary Care Provider to work on re-processing authorization denials.
• Case Management of more complex cases, with the end goal of scheduling timely referral appointments.
• Manage referrals at every stage to avoid backlog.
• Collaborate with Care Coordinator Specialist to identify patients that could benefit from program enrollment due to their conditions or needs.
• Comply with referral management policy.
• Send letters to patients when unable to reach by phone; handle all returned letters.
• Handle all incoming calls for the department in a courteous manner; provide callers with an answer to their questions as best as possible.
• Seeks assistance of supervisor when unable to process all referrals to avoid backlog and the clinical consequences of delays.
• Provides quality care to the patients of DAP Health, within the scope of practice outlined by state or federal law.
• Delivers care in accordance with established standards of care and accepted community standards.
• Understands the organization’s commitment to provide high-quality patient care. Promotes a Patient centered environment.

Skills

Excellent communication skills

Interpersonal skills

Bilingual Arabic/Farsi

Time management

Attention to detail

Computer literacy

Education

High School Diploma or GED

Job description

DAP Health is seeking a Referral Care Coordinator to ensure continuity of care for patients with referral orders and coordinate timely specialty or ancillary appointments. You will document referrals in the patient’s chart or EHR and perform data entry in the i2i system.

Responsibilities include processing referrals, obtaining authorizations, coordinating with PCPs, insurers, and patients to overcome delays in care, and maintaining accurate referral records.