Referral Clerk

Paycom; Los Angeles (CA); On-site; USD 42,000 - 60,000; Full time

Job summary

Paycom is seeking a Referral Clerk to assist patients with referral needs and connect them with external resources in Los Angeles County. The role handles referrals for insured and uninsured patients using Medpoint, RPS, and eConsult/eCW systems.

The position requires knowledge of medical terminology, strong communication, and organizational skills, with bilingual proficiency and experience in a community clinic preferred. High school diploma or equivalent is required.

Qualifications

• High School Diploma or equivalent preferred.
• Experience in a community clinic preferred.
• Knowledge in Medical Terminology.
• Excellent oral and written communication skills.
• Excellent organizational skills.
• Computer proficiency and EMR experience highly desirable.
• Bilingual required.

Responsibilities

• Process referrals for insured and uninsured patients.
• Verify patient insurance status and eligibility.
• Refer uninsured patients to public or in-house resources.
• Communicate daily with Health Care LA IPA, RPS, and eCounsult to check status.
• Document all steps in eCW until the report is received.
• Attend monthly utilization management meetings and prepare productivity reports.

Skills

Medical Terminology

Communication skills

Organizational skills

Computer proficiency

EMR experience

Bilingual

Diversity & inclusion

Education

High School Diploma

Tools

Medpoint System

RPS

eCounsult / eConsult

eCW EMR

Job description

Under the direction of the Referral Supervisor, the position assists patients with referral needs and to connect patient services with outside resources.Essential Duties and Responsibilities:Process referrals for insured and uninsured patients throughout Los Angeles County utilizing Medpoint System for insured patients and the Referral Processing System (RPS) and eConsult for uninsured patients. And uninsured patients for mammography will be referred to in-house service provided by outside agency. Process referrals with private insurances HMO and PPO.Verify patient insurance status whether patient have insurance or not. If patient is insured, check eligibility to determine specialist’s resource. If patient is uninsured, chose public resource.Refer for in-house service such as retinal screening and telederm for uninsured patient.Communicate daily with Health Care LA IPA, RPS system and eCounsult to check status.Upon approval for referral request, notice to patient appropriately such as phone and mail. And send necessary document to specialist by fax.Request report from specialists and the report will be scanned into eCW and assigned to appropriate physician. For mammogram and retinal screening, patient will be referred to specialist for necessary treatment according to the report.Each referral clerk documents all the process in ecw until we receive the report. And record necessary information to keep track on referral status on our own.Attend monthly meetings addressing utilization management for Health Care LA IPA , eConsult and RPS system. (for designated staff only)Responsible for a monthly report to measure productivity.Other duties as assigned.High School Diploma or equivalent preferred.Experience in a community clinic preferred.Knowledge in Medical TerminologyAbility to work with people of diverse cultural, educational, social, and economic backgrounds • Excellent oral and written communication skillsExcellent organizational skillsComputer proficiencyExperience utilizing an Electronic Medical Records (EMR) system is highly desirableBilingual Required