Bilingual Spanish Referral Coordinator

Responsibilities

• Maintains Electronic Health Record (EHR) tasks to capture referral requests in real time
• Gathers pertinent information via EHR or from clinical team to complete pre-authorization/referral process
• Prepares and processes referral and pre-authorization paperwork ensuring timely addressing of urgent items
• Verifies insurance information and performs eligibility checks by telephone or electronically
• Produces and submits notification letters for patients and clinicians as required
• Follows up on all referral requests and specialty report requests
• Answers, responds, and documents phone calls, reviews details and expectations about referrals with patients
• Communicates with clinical support staff regarding the status of patient referrals, care coordination, or follow-up status
• Utilizes third-party payer/insurance portals as needed
• Documents all pertinent referral or Patient Health Information (PHI) using EHR functions and/or other software systems
• Schedules referral appointments directly on behalf of patients, as needed
• Tracks referrals using the EHR or other established system
• Follows up with providers and patients regarding denials to referral requests
• Cross-trains with other Referral Coordinators to learn various service line processes
• Maintains confidentiality of PHI by following HIPAA regulations

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 with proficiency in PC-based software applications and Microsoft Office suite

Preferred 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