Referral Specialist jobs in Santa Maria, CA

Position Summary

BEYOND SPEECH THERAPY is seeking to hire a REFERRAL COORDINATOR to join our team!! If you have a desire to collaborate, motivate, and inspire, while helping others in our community, in a professional, friendly, and fun work environment, we encourage you to apply.

Beyond Speech Therapy is an outpatient clinic/private practice located on the beautiful Central Coast in Atascadero, CA. Atascadero is in San Luis Obispo County which is home to California Polytechnic State University also known to many as Cal Poly. The Central Coast also boasts several beautiful beach towns including Cayucos, Morro Bay, Cambria, Avila, Pismo and Grover Beach. We are also in the middle of beautiful wine country bordering Templeton and Paso Robles, Ca. It's a beautiful place to live with many activities for all ages to enjoy.

Beyond Speech Therapy provides services for clients of ALL ages in the areas of speech, language, pragmatics, voice, swallowing, feeding, autism, articulation, phonological awareness, auditory processing and cognitive linguistic deficits.

The referral coordinator is responsible for obtaining all necessary documents to support medical necessity, verifying insurance benefits, scheduling evaluations, and preparing new clients for their first appointment. Clear, professional and friendly communication with referring providers to obtain all documents necessary to support medical necessity is a requirement.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

1. Ensures current and standardized referral policies and workflows are fluent.

2. Prioritizes referrals by their urgency (diagnosis based) and addresses them in a timely manner.

3. Ensures complete demographic, insurance information and appropriate timely clinical information is sent to referred specialists.

4. Contacts insurance companies to ensure prior approval requirements are met. Presents necessary medical information such as, history, diagnosis and prognosis to insurance companies if deemed necessary to prove medical necessity of services.

5. Reviews details and expectations about the referral with both ordering providers and patients. Requests new referrals to be ordered when applicable.

6. Implements systems as required by EMR functionality and/or regulatory agencies.

7. Identifies and utilizes community resources; establishes relationships with servicing providers and referring personnel.

8. Point of contact for patients and specialists for any questions or rising concerns. Assist in problem solving potential issues related to scheduling, authorizations, completing new client paperwork, and understanding their insurance benefits. If unable to help, assist in finding the right point of contact to further help.

9. Initiates and completes the credentialing process for new therapists

10. Posts paper insurance payments as needed that are not processed electronically

11. Assist in insurance recoupment

Competencies

To perform the job successfully, the following competencies should be demonstrated. Attendance/Punctuality - Is consistently at work and on time, as established; ensures work responsibilities are covered when absent; arrives at meetings and appointments on time.

Beyond Speech Therapy Culture - We treat people with respect; inspire the trust of others; work with integrity and principles; uphold organizational values; follow policies and procedures; support organization's goals and values; show respect and sensitivity for cultural differences; follow instructions; respond to management direction; take responsibility for our actions; keep commitments; commit to comply with timelines and policies/procedures, complete tasks on time or notify appropriate person with an alternate plan; ask for and offer help when needed.

Communications - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; responds well to questions; demonstrates group presentation skills; participates in meetings; writes clearly and informatively; edits work for spelling and grammar; attention to details; keeps others adequately informed; selects and uses appropriate communication methods.

Customer Service for Internal and External Customers/Patients - Manages difficult or emotional customer/patient situations; responds promptly to customer/patient needs; solicits customer/patient feedback to improve service ; responds to requests for service and assistance; meets commitments.

Job Knowledge - Competent in required job skills and knowledge; exhibits ability to learn and apply new skills; keeps abreast of current developments; requires minimal supervision; displays understanding of how job relates to others; maintains confidentiality per policy and regulations; fluent in Microsoft Office programs, including Word, Excel, PowerPoint and Outlook and job related software and computers; uses resources effectively; pursues training and development opportunities; adapts to new technologies; keeps technical skills up to date.

Problem Solving - Identifies and resolves problems in a timely manner; gathers and analyzes information skillfully; develops alternative solutions; works well in group problem solving situations; uses reason even when dealing with emotional topics; adapts to changes in the work environment; changes approach or method to best fit the situation.

Planning/Organizing - Prioritizes and plans work activities; uses time efficiently; plans for additional resources; sets goals and objectives; develops realistic action plans.

Quality Management - Looks for ways to improve and promote quality; demonstrates accuracy and thoroughness; applies feedback to improve performance; monitors own work to ensure quality.

Safety and Security - Observes safety and security procedures; determines appropriate action beyond guidelines; reports potentially unsafe conditions; uses equipment and materials properly. Teamwork - Exhibits objectivity and openness to others' views; gives and welcomes feedback; establishes and maintains effective relations; exhibits tact and consideration; offers assistance and support to co-workers; works cooperatively in group situations; works actively to resolve conflicts.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience: High school diploma or general education degree (GED) and one to two years of related experience is preferred.

If you are looking to join a great team and grow professionally, this is the place for you! If you or someone you know is interested, please apply and submit your resume and/or share this listing. If you have questions and would like to speak to someone regarding this position, please call our office at 805.591.7188.

Benefits:

• 401(k) Matching up to 4% and Vesting at 3 years
• Health Insurance Options ($200 Monthly Pre-tax Employer Contribution)
• Dental insurance Options
• Life insurance Options
• Vision insurance Options
• Paid time off
• Annual Scrub Clothing Allowance
• Professional development/CEU assistance (After 1 year of employment, $200 Annual Stipend that increases upon each anniversary date of hire)
• 40 Hours of Annual Sick Leave- Lump Sum provided after 30 days and eligible for use after 90 days of employment
• Bereavement Leave
• Voting Leave
• Loss of Pregnancy Leave
• Continual On-Site Training and Support
• Annual Team Building Events
• Annual Christmas Party and Staff Appreciation Dinner
• Annual Christmas Bonus after 1 year of employment
• Gym Membership
• Additional Incentive Programs throughout the year for all employees

Schedule:

• Monday through Friday 8:30am - 5:00pm

Work setting:

• In-person

Job Type: Full-time

Pay: From $18.50 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Professional development assistance
• Referral program
• Retirement plan
• Vision insurance

Education:

• High school or equivalent (Required)

Experience:

• Health Insurance Verification Occupations: 1 year (Preferred)
• customer service: 1 year (Required)
• Medical office: 1 year (Preferred)

Work Location: In person