Referral Coordinator

SACRAMENTO NATIVE AMERICAN HEALTH CENTER INC; Sacramento (CA); On-site; USD 63,259,000 - 68,770,000; Full time

Job summary

Sacramento Native American Health Center, Inc. is seeking a Referral Coordinator to support internal and external referrals for the medical department.

You will handle prior authorizations, verify insurance eligibility, and coordinate with specialists to ensure timely care for patients. The role requires strong computer skills, excellent communication, and the ability to maintain confidentiality in a fast-paced clinical environment.

Qualifications

• High School diploma or equivalent.
• 1 year of office experience.
• Strong computer and technology skills.
• Clear oral and written communication; professional demeanor.

Responsibilities

• Receives referral requests from providers and coordinates with patient care team.
• Obtains prior authorizations for referrals and informs providers of denials.
• Verifies insurance eligibility and processes referrals with insurers.
• Requests appointments with specialty providers and tracks referral status.
• Maintains referral records and updates as needed.
• Communicates with patients and specialists to ensure timely referrals and follow-ups.
• Ensures referrals are documented in NextGen Diagnostics and Referrals sections.

Skills

Computer skills

Telephone skills

Communication skills

Organization

Writing ability

Verbal skills

Confidentiality

Education

High School diploma or equivalent

Tools

NextGen EHR/PM

Job description

Here at SNAHC, you are joining a team and company at a time of growth and transformation. You will love being surrounded by people who are as passionate as you are about healthcare and giving back to the community. Please note that individual total compensation for this position will be determined at the Company's sole discretion and the wage range for this role considers a wide range of factors including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. At SNAHC, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $22.00/HR-$24.00/HR.Position Summary:The Referral Coordinator (REFC) reports to the Referrals Manager and provides clerical and administrative support to the health center for the organization of internal and external referrals. This position will support the daily needs of all of the Referral Coordination for the medical department in the health center. The REFC is responsible for ensuring that all appointments, required documentation, insurance information and prior authorizations are established with specialty providers, insurance entities and patients.*Role may need to float to other SNAHC locationsEssential Functions:Receives referral requests from providers and communicates with them, or a member of the patient’s care team, as neededObtains prior authorizations for patient referrals to specialists and surgeries. Advises provider if authorization request is denied.Communicates with different insurance companies to process referrals appropriately and verifies eligibility of insurance for patientsRequests appointments from appropriate specialty providersVerifies eligibility of insurance for patientsCommunicates with patients and informs them of referral statusRequests consult notes once patient has been seen by specialist and closes referrals upon receipt.Communicates with Specialist regarding referral needs.Follows up on referrals with specialty providers and patients.Obtains ongoing knowledge, documentation, and updates of appropriate referral resources, required forms and key contact personsReviews and assesses medical records for referral processing.Tracks and processes referral using NextGen Diagnostics and Referrals sections in the A/P section of the SOAP note.Prioritizes and processes referrals by urgency or PCP request.Completes referral data tracking for Quality Assurance programs.Complies with all state and federal laws and regulations, as they pertain to position including; HIPAA, sexual harassment, Scope of Practice, OSHA etc.Other duties as assigned.Skills and Abilities:Excellent computer skills, preferably with Windows, including Microsoft Office SuiteExcellent telephone and communication skillsMust possess excellent organizational, writing, and verbal skills.Ability to work independently, set priorities, and work well under pressure.Ability to maintain a high degree of confidentialityCompetencies:Attention to DetailCustomer ServiceInsurance VerificationRecord MaintenanceResearchMinimum Qualifications:High School diploma or equivalent.Minimum of 1 year of experience in office settingExcellent computer and technology skills.Ability to communicate orally and in writing; professional demeanor and the ability to represent SNAHC in the community.Preferred Qualifications:Experience with NextGen EHR/PM software.Knowledge of Medi-Cal, Medicare, and managed care plansKnowledge of medical terminology and medical procedure terminologyPlease Note: This position may be grant funded. Continued employment is contingent upon renewed or additional funding and may be discontinued at the close of the grant cycle. Grant funding for any position does not impart any contractual right, either expressed or implied, to remain in Sacramento Native American Health Center, Inc.’s employment for a specific period of time. Grant funding does not affect the Sacramento Native American Health Center, Inc.’s status as an “at will” employer.