Referral & PRC Specialist – Healthcare Access

Southern Indian Health Council, Inc; Alpine (CA); On-site; USD 29,000 - 42,000; Full time

Job summary

Southern Indian Health Council, Inc. in Alpine, CA is seeking a PRC & Referrals Specialist to initiate and track referrals for medical, dental, and behavioral health services.

You will coordinate with providers, ensure pre-certification and appointment adherence, and update referral records across departments. The role requires a high school diploma or GED, at least two years of medical office experience, and excellent customer service and organizational skills.

Qualifications

• Must possess a High School diploma or GED certificate.
• Must have Two years of medical office experience.
• Knowledge of Healthcare Insurance authorization requirements and systems.
• Medical Assistant certification and experience preferred.
• Must have strong customer service focus with effective verbal and communication skills.
• Must be organized and able to manage priorities.
• Must be highly organized, detailed oriented and a team player.
• Must be at least 18 years of age.

Responsibilities

• Initiates referral process for all patients referred by SIHC providers to healthcare specialty providers for medical, dental, and behavioral health services.
• Assists in resolving pre-certification, registration, and case management concerns prior to patients' appointments.
• Tracks the progress of all referrals to ensure that referral appointments are kept.
• Works cooperatively with Medical, Dental, behavioral health, and Health Information Management Department to maintain updated records of all referrals.
• Maintains and updates SIHC referral tracking system.
• Works in conjunction with the Billing Department, insurance carriers, social services, and community health systems to assist patients in obtaining appropriate options and funding for specialty care.
• Position will provide referral services for both Alpine and Campo clinics for Medical, Dental, and Behavioral Health.

Skills

Customer service

Medical office coordination

Communication

Organization

Education

High School diploma or GED

Two years medical office experience

Medical Assistant certification (preferred)

Job description

Southern Indian Health Council, Inc. in Alpine, CA is seeking a PRC & Referrals Specialist to initiate and track referrals for medical, dental, and behavioral health services.

You will coordinate with providers, ensure pre-certification and appointment adherence, and update referral records across departments. The role requires a high school diploma or GED, at least two years of medical office experience, and excellent customer service and organizational skills.