Referral Specialist jobs in Modesto, CA

POSITION TITLE: Referral Specialist

LOCATION: Sonora, California

STATUS: Full-Time, Non-Exempt

POSITION SUMMARY:

Under the direction of the Referral Supervisor, the Referral Specialist is responsible for the referrals, diagnostic orders and surgery coordinating of patients to outside agencies, and the appropriate follow-up of those referrals per established policies and procedures.  

 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, resourcefulness and good judgment in handling functions of a sensitive nature.

 PRIMARY RESPONSIBILITIES: 

1. Expedite the delivery of referrals, diagnostics orders and surgery coordination of patients per established policies and procedures.
   1. Insurance verification and prior authorizations
   2. Transmission of all required medical records to outside facilities
   3. Facilitate appointment scheduling or rescheduling for specialty care
2. Completion of follow-up on all including:
   1. Confirming receipt of referrals
   2. Referral tracking and documentation of activities to include all elements of a referral.
   3. Receipt of medical records and attaching them to the medical chart.
3. Responds to: telephone calls, faxes and e-mails regarding referrals and provide information with respect and courtesy while being effective and efficient.
4. Ongoing knowledge, documentation and updating team of appropriate referral resources, required forms and key contact persons.
5. Connecting and communicating with medical staff to ensure fluid workflow: Providers, Medical Assistants and all other staff with in MACT also to include staff at outside facilities.
6. Maintain and manage daily tasks and work flow.  
7. Must adhere to the MACT Health Board, Inc. Corporate Code of Conduct.
8. Maintain confidentiality with patient information at all times; adheres to all HIPAA guidelines/regulations.
9. Adheres to all MACT policy and procedures.
10. Other duties as assigned. 

KNOWLEDGE AND SKILLS FOR POSITON: 

1. 1. Medical Terminology
2. 2. Knowledge of medical computer programs: Next Gen EPM, EHR, i2i Tracks, Epic and other HIE’s. 
3. Knowledge and training in the HIPAA regulations related to patient care documentation, eligibility process and compliance to the regulations.
4. Good detail analysis, accuracy, oral and written communication, patience and tact required. 
5.  Ability to prioritize tasks and complete assignments in a timely manner.
6. Microsoft Word, Outlook, Excel and Power Point knowledge for documentation and preparation of reports, training and presentations.
7. Broad communication skills.
8. Flexibility with workflow and tasks.

POSITION REQUIRES: 

1. Knowledge of EHR-EPM systems including Next Gen & i2i

2. Ability to visit sites within the organization for training and meetings.  

3. Valid unrestricted California Driver’s license and the ability to be insurable under MACT’s automobile insurance.

 MINIMUM QUALIFICATIONS:

1. High school diploma or equivalent.
2. Medical Terminology.
3. Medical Office experience.
4. One year of experience as a referral clerk or similar type duties working with referral of patients for treatment.
5. One year of experience as a medical receptionist, medical assistant, or procedure scheduler or satisfactory completion of a medical receptionist/medical assistant training program.

MANDATORY REQUIREMENTS:

1. Pass an Occupational Health Screening
2. 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.

1. Clean DMV driving record and MACT auto insurance driving eligibility (determined by auto insurance carrier). 

  AMERICAN INDIAN PREFERENCE: 

Preference in filing of a vacancy will be given to qualified American Indian applicants in accordance with the Preference Act of 1934 (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.