Referral Coordinator - Orthopedic Clinic at Cypress Healthcare Partners

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Full Time

Start Date

Immediate

Expiry Date

26 May, 26

Salary

26.0

Posted On

25 Feb, 26

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Communication Skills, Organization, Workload Management, Accuracy, Authorization, Tracking, Documentation, ICD-10 Codes, CPT Codes, Prior Authorization, Medical Terminology, Insurance Processes, System Navigation, EHR Scanning, Front Office Coverage

Industry

Hospitals and Health Care

Description

Salinas Valley Health Clinics - Orthopedic Clinic SUMMARY The person in the position of the Referral Coordinator must be able to perform the duties described within as well as to meet the company’s qualifications. The referral coordinator must have exceptional communication skills to communicate effectively with clinic managers and referring providers. Individuals must be organized, and be able to manage a demanding workload with accuracy. ESSENTIAL DUTIES AND RESPONSIBILITIES specific to the authorization department include the following: * Responsible for the completion of all incoming/outgoing referrals as assigned. * Maintain ongoing tracking and appropriate documentation on the status of referrals. Referrals should be addressed in timely manner, by reviewing and reconciling overdue and/or pending orders in the work queue. * Referrals should be addressed in timely manner, by reviewing and reconciling overdue and/or pending orders in the work queue. Escalate routine referral delays more than 14 business days. * Assemble information concerning patient’s clinical background and referral needs. * Knowledge and understanding of ICD-10 and CPT Codes * Contact insurance companies to ensure all prior authorization needs are met. Present necessary medical information such as history, diagnosis and prognosis. * Be the system navigator and point of contact for patients with outstanding referrals, assuring patient is aware of referral by reviewing details and expectations. * Contact external offices to ensure referral is received, to obtain patient appointment date, including all relating information. * Ensure the patient’s chart is up to date with demographics, insurance information, and information on specialist consults; scanning appropriate follow-up documents into system. * Scans all patient visit documentation into EHR * Covers various front office positions as needed * Other duties as assigned QUALIFICATIONS For the employee to execute 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 The employee performing this position is expected to hold a High school diploma or general education degree (“GED”); and at least three months (preferably six months) related experience (e.g., health care setting, customer service, etc.) and/or training; or equivalent combination of education and experience. The employee performing this position is expected to have some experience with medical terminology and understanding of medical insurance process. S/he must be able to understand or quickly learn about the differences between and among patients with private insurance, Medicare, Workers’ Compensation and self-paying patients, etc. PREFERRED Bilingual may be required during certain shifts. SUPERVISORY RESPONSIBILITIES This job has no supervisory responsibilities. CONDITIONS OF EMPLOYMENT Salinas Valley Health Clinics requires you to prove that you have received the COVID-19 vaccine or have a valid religious or medical reason not to be vaccinated. Proof of identity and legal authority to work in the U.S. is a condition of employment. Cypress Healthcare Partners/Salinas Valley Health Clinics will not sponsor applicants for work visas.

Responsibilities

The Referral Coordinator is responsible for completing all incoming and outgoing referrals, maintaining accurate tracking, and ensuring timely resolution of overdue orders, including escalating delays beyond 14 business days. This role also involves contacting insurance companies for prior authorizations and serving as the primary system navigator for patients regarding outstanding referrals.