Supervisor, Referrals

SAC Health; San Bernardino (CA); On-site; USD 60,000 - 80,000; Full time

Benefits offered by this job

Full benefits package

PTO accrual

Job summary

SAC Health in San Bernardino, CA, is seeking a Supervisor, Referrals to lead the referral/authorization workflow and supervise the staff to ensure timely, accurate processing. You will guide providers on referral ordering and coordinate with insurance and outside groups.

This role supports continuous improvement, reviews documentation for accuracy, coaches team members, and participates in interview and onboarding processes. Travel to other SAC Health clinics may be required.

Qualifications

• Minimum two years of supervisory or leadership experience.
• Two years of medical office or outpatient experience preferred.
• Medical knowledge and experience in medical referral processing, ICD/CPT coding preferred.
• EPIC certification for the module you have been hired into is required.
• Proficient data entry (≈35 wpm) and ability to operate standard office equipment.

Responsibilities

• Initiate continuous improvement methodologies, including QA reviews to ensure compliance with insurance and SAC Health guidelines.
• Handle escalated patient issues and assist in resolution.
• Coach staff and identify areas of improvement; conduct regular one-on-one meetings.

Skills

Supervisory experience

Medical office experience

ICD/CPT knowledge

Data entry (35 wpm)

Education

High School Diploma

EPIC certification

Tools

MS Office

Job description

Who We Are:

SAC Health empowers our patients and their families to live vibrant and healthy lives through culturally responsive, exceptional care. Patient-centered, whole-person care. Our unique, full scope, team-based approach is what makes SAC Health the provider of choice for patients.

Top-Tier Patient Satisfaction Scores | Largest Teaching Health Center FQHC | 11 Locations offering 44 Specialties | Participation in NHSC & NCLRP loan forgiveness

What We Are Looking For

The Supervisor, Referrals is responsible for understanding the referral/authorization process at the highest level, and supervising the referral staff to ensure compliance with processing guidelines. Ensures accurate and timely review and entry of authorizations and consult notes. Processes and ensures completion of referral orders to specialists. May place or assist in processing of orders under the direction of approved protocols. Offers guidance to providers on the ordering of referrals, as needed. Recommends new processes to improve efficiency within the department. Monitors staff productivity and provides coaching in areas of improvement. Reports to the Referrals Manager. Occasional travel to other SAC Health clinics may be required.

Schedule: 5 days per week, 8 hours per day, Monday - Friday 7:30am-4:00pm | Location: Brier Clinic, San Bernardino, CA

ESSENTIAL FUNCTIONS AND DELIVERABLES

• Responsible for initiating continuous improvement methodologies, including quality assurance reviews to ensure compliance is maintained in accordance to insurance and SAC Health guidelines.
• Handles escalated patient issues and assists in resolving.
• Identifies internal and external challenges related to referrals and recommends new processes to improve efficiency within the department. Responsible for coaching staff and identifying areas of improvement.
• Meets with staff on a regular basis, holding documented one-on-one meetings to review issues with staff and update on progress.
• Assists in the interviewing process for new staff and provides valuable input for the annual evaluation of staff.
• May place or assist in processing of orders under approved standing orders and protocols as needed.
• Reviews referral order documentation to determine if documentation supports requested referral and reviews for accuracy of codes.
• Processes referrals, authorizations, and specialty notes. Verifies accuracy of authorizations and ensures specialty notes are received timely to facilitate on-going authorizations for continued care.
• Serves as liaison and referral resource to clinic staff, outside medical groups, and patients.
• Maintains up-to-date knowledge and familiarity with insurance policies, referral, and authorization processes. Works with insurance companies / managed care groups to ensure pre-visit information is sent to patients as needed.

QUALIFICATIONS

• Education: High School Diploma or equivalent required. Bachelor's degree preferred.
• Licensure/Certification: Valid CA driver's license and active auto insurance. As a requirement of this position you must receive EPIC certification for the module you have been hired into.
• Experience: Minimum two (2) years supervisory or leadership experience required. Two (2) years of medical office or outpatient experience preferred. Medical knowledge and experience in medical referral processing, ICD and CPT coding preferred.
• Essential Technical/Motor Skills: Must have proficient computer skills including data entry (35wpm). Must be able to use a variety of office equipment including fax machine, scanner, printer and copier.
• Interpersonal Skills: Must demonstrate the ability to foster teamwork and contribute to the development of an effective work environment; exceptional communication, organizational and office and interpersonal skills.
• Essential Mental Abilities: Requires critical thinking skills. Must be flexible to perform a variety of tasks. Must be well organized. Must be able to handle multiple telephone lines ringing simultaneously.
• Work Eligibility: Must be legally authorized to work in the United States on a full-time basis. Must not now or in the future require sponsorship for employment visas.

EEO

SAC Health is committed to fostering a diverse, equitable and inclusive work environment and is committed to being an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

Full Benefits Package

Industry Leading PTO Accrual (accrued per pay period) | Sick Leave | Paid Holidays | Paid Jury Duty, Bereavement | SAC Health Covers approximately 85% of Team Member health premium costs (may vary w/benefit plan selection) | Retirement - up to 8% employer contribution | Continuing Education and Learning Benefits | Annual Mission Trip and much more!

Learn More About the Work We Do

SAC Health's Mission: SAC Health's mission is to reflect the healing ministry & love of Jesus Christ through healthcare, education & partnerships that empower our communities to flourish.

SAC Health's Core Values: Quality Healthcare - Teamwork - Wholeness - Integrity - Compassion - Excellence - Humble Service - Respect