We are looking for 2 Referral Coordinators to join our team in Midtown!

Job Summary: The Referral Coordinator (REFC) reports to the Referrals Manager and provides clerical and administrative support to the health center for the organization of internal and external referrals. This position will support the daily needs of all of the Referral Coordination for the medical department in the health center. The REFC is responsible for ensuring that all appointments, required documentation, insurance information and prior authorizations are established with specialty providers, insurance entities and patients.

Qualifications:

• High School diploma or equivalent.
• Minimum of 1 year of referral coordination experience required
• Excellent computer and technology skills.
• Ability to communicate orally and in writing; professional demeanor and the ability to represent the clinic in the community.
• EMR experience, NexGen preferred
• Knowledge of Medi-Cal, Medicare and managed care plans preferred
• Knowledge of medical terminology and medical procedure terminology preferred

Essential Functions:

• Receives referral requests from providers and communicates with them, or a member of the patient’s care team, as needed
• Obtains prior authorizations for patient referrals to specialists and surgeries. Advises provider if authorization request is denied.
• Communicates with different insurance companies to process referrals appropriately and verifies eligibility of insurance for patients
• Requests appointments from appropriate specialty providers
• Verifies eligibility of insurance for patients
• Communicates with patients and informs them of referral status
• Requests consult notes once patient has been seen by specialist and closes referrals upon receipt.
• Communicates with Specialist regarding referral needs.
• Follows up on referrals with specialty providers and patients.
• Obtains ongoing knowledge, documentation, and updates of appropriate referral resources, required forms and key contact persons
• Reviews and assesses medical records for referral processing.
• Tracks and processes referral using NextGen Diagnostics and Referrals sections in the A/P section of the SOAP note.
• Prioritizes and processes referrals by urgency or PCP request.
• Completes referral data tracking for Quality Assurance programs.
• Complies with all state and federal laws and regulations, as they pertain to position including; HIPAA, sexual harassment, Scope of Practice, OSHA etc.
• Other duties as assigned.

Skills and Abilities:

• Excellent computer skills, preferably with Windows, including Microsoft Office Suite
• Excellent telephone and communication skills
• Must possess excellent organizational, writing, and verbal skills.
• Ability to work independently, set priorities, and work well under pressure.
• Ability to maintain a high degree of confidentiality

Schedule: Monday - Friday, 8am to 5pm, 1 hour lunch

Contract Term: 6 month contract with ability to be hired on direct at the end dependent on performance

Pay: Pay range is based on experience in referrals

Pay and Benefits

The pay range for this position is $22.00 - $24.00

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a hybrid position in Sacramento,CA.

Application Deadline

This position will be accepting applications until Dec 22, 2024.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

Diversity, Equity & Inclusion

At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

• Hiring diverse talent
• Maintaining an inclusive environment through persistent self-reflection
• Building a culture of care, engagement, and recognition with clear outcomes
• Ensuring growth opportunities for our people

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.

Salary : $22 - $24