Referral Specialist

MACT Health Board Inc; Sonora (CA); On-site; USD 73,207,000 - 82,455,000; Full time

Job summary

MACT Health Board Inc in Sonora, California, seeks a detail-oriented Referral Specialist to manage referrals, diagnostic orders, and surgery coordination for patients in a clinical setting. You will verify insurance, obtain authorizations, transmit records, and schedule appointments to ensure timely care.

Responsibilities include tracking referrals, ensuring complete documentation, responding to inquiries, and collaborating with providers and MACT staff at outside facilities while upholding

Qualifications

• High school diploma or equivalent.
• Medical Terminology knowledge and medical office experience.
• One year of referral clerk or scheduling experience.
• Knowledge of medical computer systems: Next Gen EPM, EHR, i2i Tracks, Epic.
• HIPAA regulations knowledge and compliance.
• Good detail, accuracy, communication skills and tact.
• Current BLS/ALS certificate and valid ID per I-9 requirements.

Responsibilities

• Expedite referrals, diagnostics orders and surgery coordination with outside facilities.
• Insurance verification and prior authorizations.
• Transmit required medical records to outside facilities and schedule appointments.
• Follow-up on referrals, document activities and attach records to charts.
• Respond to inquiries via phone, faxes and e-mails with respect and efficiency.
• Maintain knowledge of referral resources, forms and key contacts.

Skills

Detail oriented

Oral communication

Written communication

Patience

Tact

Education

High school diploma or equivalent

Medical Terminology

Tools

Next Gen EPM

Epic

i2i Tracks

EHR

Job description

Since 1969, MACT Health Board’s mission has been to improve the health status of the American Indian and Alaskan Native population. Our goal is to continue to provide high quality care to our patients throughout a variety of services, including Medical, Behavioral Health, Chiropractic, Dental, Optometry, Massage Therapy, Women’s Health, and more.

Why MACT Health Care Inc?

Are you searching for a career that offers more than just a paycheck? A career where your professional skills directly empower the health and well-being of our local communities? At MACT Health Board, that’s not just an idea—it’s our daily mission and we invite you to explore our Career Opportunities. You won’t be just another employee; you’ll be a valued member of a team committed to making a difference and we know that taking care of our community starts with taking care of our own. We reward our employees with competitive compensation, benefit options and provide training and advancement opportunities to provide you with the skills to succeed in your future! Our careers offer a unique balance of philanthropic opportunities, cultural preservation and individual value! When you join MACT, you’ll enjoy:

• Medical, Dental, Vision, and life insurance benefits at no-cost to the employee
• 403(b) retirement plan, PTO including vacation, sick time, paid holidays and more
• Balanced working hours; Monday-Friday 8-5pm.
• Student Loan Repayment Program
• Direct Student Loan Contributions: Our BenefitED program allows us to make direct quarterly contributions to your student loans to help you pay them off faster
• Continuing Education credits: We empower our providers to stay at the top of their field. We offer reimbursement for continuing education and licensure fees.
• Competitive Salary of $25.56-$28.82 hourly

Who you are:

We are seeking a detail oriented Referral Specialist for a Full role working in a clinical setting. As a member of the health care team, the Referral Specialistis responsible for the referrals, diagnostic orders and surgery coordinating of patients to outside agencies, and the appropriate follow-up of those referrals.The Referral Specialist will:

• Expedite the delivery of referrals, diagnostics orders and surgery coordination of patients including:
  • Insurance verification and prior authorizations
  • Transmission of all required medical records to outside facilities
  • Facilitate appointment scheduling or rescheduling for specialty care
• Completion of follow-up on all including:
  • Confirming receipt of referrals
  • Referral tracking and documentation of activities to include all elements of a referral.
  • Receipt of medical records and attaching them to the medical chart.
• Respond to: telephone calls, faxes and e-mails regarding referrals and provide information with respect and courtesy while being effective and efficient.
• Demonstrate ongoing knowledge and documentation of appropriate referral resources, required forms and key contact persons.
• Connect and communicate with medical staff such as providers, medical assistants, and other MACT staff at outside facilities, to ensure efficient workflows

What you need:

• High school diploma or equivalent.
• Medical Terminology.
• Medical Office experience.
• One year of experience as a referral clerk or similar type duties working with referral of patients for treatment.
• One year of experience as a medical receptionist, medical assistant, or procedure scheduler or satisfactory completion of a medical receptionist/medical assistant training program.
• Knowledge of medical computer programs: Next Gen EPM, EHR, i2i Tracks, Epic and other HIE’s.
• Knowledge and training in the HIPAA regulations related to patient care documentation, eligibility process and compliance to the regulations.
• Good detail analysis, accuracy, oral and written communication, patience and tact required.
• Current BLS/ALS certificate
• Must pass Occupational Health Screening.
• Must possess a valid form of identification as listed on the U.S. Department of Justice I-9 form, verified using the E Verify system.
• Clean DMV driving record and MACT auto insurance driving eligibility (determined by auto insurance carrier).

The position requires an awareness and keen appreciation of American Indian traditions, customs, and socioeconomic needs and the ability at all times to meet and deal effectively in contacts with Indian health organizations which requires tact, courtesy, discretion, resourcefulnessand good judgment in handling functions of a sensitive nature.

AMERICAN INDIAN PREFERENCE:

Preference in filling of a vacancy will be given to qualified American Indian applicants in accordance with the Preference Act (Title 25, U.S. Code, Sections 472 & 473) and Public Law 93-638, provided the applicant has submitted appropriate verification of Indian preference for employment. Other than the aforementioned requirement, the MACT Health Board, Inc. is an Equal Opportunity Employer.

NOTICE OF DRUG-FREE WORKPLACE ACT REQUIREMENT:

MACT Health Board, Inc. is required to implement the Drug-Free Workplace Act of 1988, 45 CFR Part 79, Subpart F. As such it is unlawful for employees to manufacture, distribute, dispense, possess, or use a controlled substance on the job site. Employees who are reasonably suspected of violating this act may be subject to drug testing as a condition of employment. Employer required fitness examinations shall include drug testing as evidence of employee and employer compliance with the Drug-Free Workplace Act.