Referral Coordinator: SVH Orthopedics & Neurosurgery

Doctors On Duty; Salinas (CA); On-site; USD 33,000 - 37,000; Full time

Job summary

Cypress Healthcare Partners/Salinas Valley Health Clinics in Salinas, CA is seeking a Referral Coordinator to manage referrals, track status, and ensure accurate documentation across patient records and insurer communications.

The role requires exceptional organization, the ability to handle a demanding workload, knowledge of ICD-10 and CPT codes, and coordination with clinic managers and providers.

Qualifications

• Must have strong communication with clinic managers and referring providers.
• Experience in healthcare or similar customer service roles preferred.
• Knowledge of medical terminology helpful.

Responsibilities

• Process all incoming/outgoing referrals as assigned.
• Maintain tracking and documentation on referral status; address overdue items.
• Escalate delays beyond 14 business days as needed.
• Assemble patient clinical background and referral needs.
• Know ICD-10 and CPT codes; liaise with insurers for prior authorizations.
• Serve as system navigator for patients with outstanding referrals.
• Update patient charts with demographics and insurance data; scan documents.
• Scan all visit documentation into the EHR; cover front-office duties as needed.

Skills

Communication skills

Organizational skills

Attention to detail

Education

High school diploma or GED

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Full Time Clerical Salinas, CA, US

2 days ago Requisition ID: 2660

Salary Range: $24.00 To $27.00 Hourly

SUMMARY

The person in the position of the Referral Coordinator must be able to perform the duties described within as well as to meet the company’s qualifications. The referral coordinator must have exceptional communication skills to communicate effectively with clinic managers and referring providers. Individuals must be organized, and be able to manage a demanding workload with accuracy.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Specific to the authorization department include the following:

• Responsible for the completion of all incoming/outgoing referrals as assigned.
• Maintain ongoing tracking and appropriate documentation on the status of referrals. Referrals should be addressed in timely manner, by reviewing and reconciling overdue and/or pending orders in the work queue.
• Referrals should be addressed in timely manner, by reviewing and reconciling overdue and/or pending orders in the work queue. Escalate routine referral delays more than 14 business days.
• Assemble information concerning patient’s clinical background and referral needs.
• Knowledge and understanding of ICD-10 and CPT Codes
• Contact insurance companies to ensure all prior authorization needs are met. Present necessary medical information such as history, diagnosis and prognosis.
• Be the system navigator and point of contact for patients with outstanding referrals, assuring patient is aware of referral by reviewing details and expectations.
• Contact external offices to ensure referral is received, to obtain patient appointment date, including all relating information.
• Ensure the patient’s chart is up to date with demographics, insurance information, and information on specialist consults; scanning appropriate follow-up documents into system.
• Scans all patient visit documentation into EHR
• Covers various front office positions as needed
• Other duties as assigned

QUALIFICATIONS

For the employee to execute this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION and/or EXPERIENCE

The employee performing this position is expected to hold a High school diploma or general education degree (“GED”); and at least three months (preferably six months) related experience (e.g., health care setting, customer service, etc.) and/or training; or equivalent combination of education and experience. The employee performing this position is expected to have some experience with medical terminology and understanding of medical insurance process. S/he must be able to understand or quickly learn about the differences between and among patients with private insurance, Medicare, Workers’ Compensation and self-paying patients, etc.

PREFERRED

Bilingual may be required during certain shifts.

SUPERVISORY RESPONSIBILITIES

This job has no supervisory responsibilities.

CONDITION OF EMPLOYMENT:

Proof of identity and legal authority to work in the U.S. is a condition of employment. Cypress Healthcare Partners/Salinas Valley Health Clinics will not sponsor applicants for work visas.