Referral Coordinator - Temporary
TrueCare is a trusted healthcare provider serving San Diego and Riverside Counties, offering compassionate and comprehensive care to underserved communities. We are committed to making healthcare accessible to everyone, regardless of income or insurance status. With a focus on culturally sensitive, affordable services, TrueCare aims to improve the health of diverse communities. Our vision is to be the premier healthcare provider in the region, delivering exceptional patient experiences through innovative, integrated care.
The Referral Coordinator is responsible for the coordination, processing, obtaining prior
authorizations, and requesting reports for a variety of medical referrals for services/procedures as requested by medical providers. The Referral Coordinator will also collaborate with other referral staff, medical providers, and patient care support staff to effectively communicate and ensure successful tracking and coordination of referrals successful tracking and coordination of referrals.
Duties & Responsibilities:
- Oversees and coordinates the daily activities of the department with regards to quality, timeliness, accuracy and consistency.
- Creates and maintains schedules, coverage plans and assignments for assigned staff; and manages Paid Time Off (PTO).
- Monitors staff time and attendance processes daily and makes appropriate corrections, as needed.
- Coordinates, schedules and trains staff on referral submission and follow up procedures.
- Works closely with Referral Manager to ensure departmental goals are being achieved; advises manager of issues that impede goals from being met.
- Ensures complete tracking and follow-up on all referral requests and specialty report requests.
- Monitors workflow and ensures that referral processing and follow-up are completed within the guidelines established by the department.
- Assists in tracking and reporting on staff productivity.
- Monitors quality by performing audits and ensures all associated processes are followed consistently.
- Makes recommendations regarding changes, improvements or enhancements to the referrals process and assists with implementation; and assists with developing departmental protocols.
- Serves as point of contact and performs troubleshooting when problem situations arise in the referrals process.
- Addresses and resolves complaints related to customer service; escalates to Referral Manager, when necessary.
- Ensures proper referral documentation is created and maintained according to TrueCare protocols.
- Provides coverage for processing referrals.
- Reviews referrals for completeness and follows up with additional information, if necessary.
- Ensures proper use of Current Procedural Terminology (CPT) and current International Classification of Diseases (ICD) codes to meet the requirements of third-party payers and specialty clinics to ensure minimal delay in securing referral appointments or pre-authorization. Follow-up with clinician as needed.
- Utilizes Electronic Health Record (EHR) functions and/or other software systems to document all pertinent referral or Patient Health Information (PHI).
- Conducts 1:1 meetings with assigned staff.
- Completes evaluations for assigned staff.
- Maintains confidentiality of PHI by following all applicable Health Insurance Portability and Accountability Act (HIPAA) regulations.
- Conducts and/or attends meetings, task forces and committees as appropriate.
Required Qualifications:
- High school diploma or equivalent.
- At least one year of experience as a Medical Receptionist or Medical Assistant (MA) in an outpatient setting, or in medical case management.
- Bilingual in English and Spanish.
- Knowledge of medical terminology and procedures, and CPT and ICD codes.
- Availability to work outside of normal shifts (i.e., 8am to 5pm and on Saturdays).
- Computer literacy working with PC-based software applications and proficiency with the Microsoft Office suite, including Outlook, Word and Excel.
Desired Qualifications:
- Two years of referral coordination or medical assisting experience.
- Understanding of insurance providers, their portals and their expectations for authorization approvals.
- Medical Assistant certification.
- Experience working in a community health center.
- Working knowledge of EHR and registration/billing software
Benefits:
- Competitive Compensation
- Competitive Time Off
- Low-cost health, dental, vision & life insurance
- Tuition Reimbursement, Employee Assistance program
TrueCare is committed to a policy of Equal Employment Opportunity and will not discriminate against an applicant or employee on the basis of race, color, religion, creed, national origin, ancestry, sex, gender, age, physical or mental disability, veteran or military status, genetic information, sexual orientation, gender identity, gender expression, marital status, or any other characteristic protected by applicable federal, state, or local law. Our goal is to promote and ensure authentic inclusion, belonging and support for all team members recruited or employed here. In the spirit of pay transparency, we are excited to share the base salary range for this position.
If you are hired at TrueCare, your final base salary (within the pay range), will be determined based on factors such as education, knowledge, skills, and experience. In addition to those factors, we believe in the importance of pay equity and consider the internal equity of our current team members when determining any final offer. Please keep in mind that the range mentioned above is the full base salary range for the role. Hiring at the maximum of the range would not be typical to allow for future and continued salary growth. We also offer generous benefits and retirement plans.