Referral Coordinator (UGSC)

Sante Health System, Inc.; Fresno (CA); On-site; USD 42,000 - 64,000; Full time

Benefits offered by this job

competitive pay

excellent benefits including medical, 

dental, vision, and life insurance

401k retirement plan

paid time off

opportunities for advancement

Job summary

Sante Health System, Inc. is seeking a full-time Referral Coordinator to join our UroGynecology Specialty Center Recreation Office in Fresno, CA. The role focuses on coordinating and scheduling specialist appointments and obtaining prior authorizations for patients.

The Referral Coordinator will manage referrals, contact patients and insurance providers, and maintain accurate records while delivering excellent patient service in a fast-paced medical setting.

Qualifications

• High school diploma or GED required.
• Minimum one year work experience, preferably in a medical office setting.
• Experience with medical terminology and various insurance products and requirements desirable.
• Word processing and computer experience required.
• Exceptional people and communication skills; multi-tasking in fast-paced environment.

Responsibilities

• Schedules patient appointments with specialists or faxes referral information to the specialist's office.
• Arranges for all appropriate information to be sent to the specialist prior to appointment.
• Contacts patient with appointment time and place.
• Contacts patients' insurance company to obtain benefit information and any required prior authorizations.
• Answers telephone calls regarding referral follow ups.
• Maintains up-to-date specialist list for HMO patients.
• Records referral information in patient charts under insurance.
• Provides general information on insurance policies and procedures.
• Enters patient, insurance, specialist, and visit data in the system.
• Stays current on insurance benefit changes.
• Maintains patient confidentiality.
• Attends required meetings and committee work.

Education

High school diploma or GED

Tools

EMR systems

Job description

Sante Health System is ready to add a full-time Referral Coordinator to one of our busy medical sitesUroGynecology Specialty Center Recreation Office in the Fresno, CA area. This position is responsible for coordinating and scheduling specialist appointments for our patients, including obtaining any necessary prior authorizations.

REQUIREMENTS

• High school diploma/GED equivalent required.
• Minimum one year work experience, preferably in a medical office setting.
• Experience with medical terminology and various insurance products and requirements desirable.
• Word processing and computer experience required.

Candidates should have exceptional people and communication skills, be highly skilled in multi-tasking in a fast paced environment, a commitment to achieving a high level of accuracy and attention to detail, and a no-task-too-small approach to the work.

ESSENTIAL DUTIES AND RESPONSIBILITIES

1. Schedules patient appointments with specialists, or faxes referral information to the specialist's office so that they may schedule the appointment.
2. Arranges for all appropriate information to be sent to the specialist prior to the patient's scheduled appointment date and time.
3. Contacts patient with the appointment time, place, etc.
4. Contacts patients' insurance company to obtain benefit information and any required prior authorizations.
5. Answers all telephone calls in a timely manner regarding referral follow ups.
6. Maintains up-to-date specialist list for HMO patients.
7. Records all referral information in patient's chart under insurance information.
8. Provides general information on insurance policies and procedures.
9. Enters information in the computer regarding patient, insurance, specialist, specialty, number of visits and consult letters received.
10. Remains current on insurance benefit changes.
11. Maintains patient confidentiality.
12. Attends required meetings and participates in committees as requested.
13. In the spirit of teamwork, employees are expected to follow any other job-related instructions and to perform any other job-related duties as requested.

PERFORMANCE REQUIREMENTS

Knowledge, Skills and Abilities

• Knowledge of business office procedures.
• Knowledge of managed care products such as HMOs, PPOs, EPOs and government run medical programs.
• Knowledge of grammar, spelling and punctuation to type patient information.
• Working knowledge of workers' compensation.
• Skill in operating a computer and fax machine.
• Skill in greeting patients and answering the telephone in a pleasant and helpful manner.
• Ability to speak clearly and concisely.
• Ability to read, understand and follow oral and written instructions.
• Ability to establish and maintain effective working relationships with patients, employees, other physician offices and insurance companies.

THE DAY-TO-DAY

Each day as a Referral Coordinator is a great opportunity to utilize your customer service and organizational skills to ensure that our patients receive the care they need. Keeping your eye out for incoming referrals on our EMR systems, you are able to quickly contact patients about scheduling appointments with specialists, procedures, radiology exams, appointments for nutritional consults, and psychological consults. In addition to talking with our patients over the phone, you also contact their insurance companies to obtain patient benefit information and any required pre-authorizations.

Our specialists depend on you not only for efficient scheduling but also to arrange for the appropriate information to be sent before the patient's scheduled appointment. You also notify hospitals of any direct admits. With great attention to detail, you keep all patient and referral records organized and up-to-date. You enjoy the variety in your job and the opportunity to provide excellent customer service. You feel accomplished knowing that you have helped our patients.

ABOUT SANTE HEALTH SYSTEM

Sante Health System is a Management Services Organization that serves multiple clients. "Sante" is the French word for health. Our name symbolizes our commitment to good health, progressive care, and leadership in our community.

Sante is one of the largest healthcare claims and billing management companies in Central California. The strength of Sante is the extraordinary network of physicians, health plans, and other health service providers it offers the people of our valley. Sante coordinates with physicians, health plans, hospitals, and ancillary providers to ultimately benefit the patient in a managed care environment. Sante Health System provides numerous client services such as billing, claims processing, contracting, credentialing, finance, human resources, information services, marketing/communications, physician services, practice management, provider relations, quality improvement, and utilization management.

With over 30 years of service to the community, we deeply understand that we would not be successful in enhancing the quality of life of our patients without our incredible team. This is why we have created a work culture that is comprised of talented, driven, dedicated, innovative, and service-driven professionals.

We provide

• competitive pay
• excellent benefits including medical, dental, vision, and life insurance
• 401k retirement plan
• paid time off
• opportunities for advancement

Being part of our team is like being part of a big family. Join our team and make Sante Health System your home away from home.