Referrals Specialist (San Ysidro, CA)

San Ysidro Health; San Diego (CA); On-site; USD 42,000 - 56,000; Full time

Job summary

San Ysidro Health is seeking a referrals processing specialist to handle faxes and referrals within the health system. You will screen, upload to EHR, coordinate with providers, and ensure timely follow-up while maintaining professional communication with internal and external partners.

In this role, you will review referrals, update appointment details, and help close the loop on patient visits. A high school diploma or equivalent plus healthcare exposure is required, with bilingual

Qualifications

• Minimum 6 months’ experience in a healthcare setting including front and back office and/or referral authorization.
• Knowledge of health plan eligibility, guidelines, coding, and data processing is helpful.
• Basic medical terminology and computer skills.
• Typing of 35 wpm.
• Ability to multi-task.
• Be attentive to patient needs and concerns.

Responsibilities

• Receives and processes e-faxes promptly with attention to quality, accuracy, and completeness.
• Screens e-faxes, uploads documents to EHR, assigns tasks to referring provider, updates initial referral, and forwards to HIS.
• Responds to inquiries about fax status with regular, timely updates.
• Maintains professionalism in verbal and non-verbal communication.
• Reviews referral log weekly to close the referrals loop and tracks appointment outcomes.
• Updates referral with appointment date/time and follow-up if needed.

Skills

Bilingual Spanish/English

Typing 35 wpm

Multi-tasking

Team player

Basic computer skills

Health plan eligibility knowledge

Attentive to patient needs

Education

High School Diploma/GED or 3 years relevant experience

Tools

EHR

Job description

Position Summary:

Responsible for timely processing, documenting, and follow-up of faxes received in referrals folders.

Essential Functions of the Job:

• Receives and processes e-faxes in a timely manner with attention to quality, accuracy, and completeness of work. Plans in advance to ensure tasks are complete.
• Screens e-faxes received, uploads documents to EHR, tasks referring provider, updates initial referral, follow up if needed, and proceeds to forward a copy of the document to HIS.
• Responds to inquiries regarding current status of faxes by assessing the request and evaluating the circumstances to provide regular, consistent, and timely information as needed.
• Demonstrates professionalism both verbally and non-verbally.
• Listens to customers (internal and external) and addresses needs and is accountable and responsive to customer concerns.
• Seeks different points of view and leverages diverse perspectives.
• Meets established or agreed upon deadlines.
• Arrives on time and prepared for work
• Uses sound judgement and assumes responsibility and accountability for decisions, actions, and performance.
• Works on closing the referrals loop; review the referral log weekly to determine which patients have kept their specialty or consultation appointments.
• Updates the referral with date and time of the appointment.
• Documents if patient kept their appointment, reach out to specialist or facility to request visit notes or results to be e-faxed to the Referrals Department’s main fax number within 5 working days of visit as needed.

Additional Duties and Responsibilities:

• Maintains established departmental policies and procedures.
• Displays and promotes behavior consistent with SYHealth’s policies and core values, and adheres to standards of ethical conduct and professionalism.
• Enhances professional growth and development through participation in training programs, meetings, and workshops.
• Attends meetings as required and participates in committees as directed.
• Works cooperatively with others as a team to meet shared objectives.
• Fosters an environment that encourages group participation and inclusiveness.
• Takes initiative to help improve processes and identify root causes, maintaining a focus on solutions.
• Performs other related duties as requested.

Job Requirements

Education Required:

High School Diploma/GED, or a minimum of 3 years of relevant experience in lieu of diploma.

Certifications/Licenses Required:

Valid CA driver’s license and access to an insured vehicle.

Experience and Required Skills:

• A minimum of 6 months’ experience in a healthcare setting to include both front and back office and/or referral authorization experience.
• Knowledge of programs, health plan eligibility and guidelines, coding, and data processing are helpful.
• Basic medical terminology and computer skills.
• Typing of 35 wpm.
• Ability to multi-task.
• Be attentive to patient needs and concerns.
• Willing to work together with others as a team.

Verbal and Written Skills Required to Perform the Job:

Bilingual (Spanish/English). Good verbal and written communication skills in both languages.

Equipment Used:

Computer, EHR, fax machine, and desk phone.

Working Conditions and Physical Requirements:

Prolonged sitting position, walking, constant telephone communication.

Universal Requirements:

Pre-employment requirements include I-9, physical, positive background and reference check results, complete application, new hire orientation, pre-employment PPDs.