Referrals Clerk

Referral Clerk

The Referral Clerk will screen and support patients in connecting with specialty offices based on medical provider referrals.

• Communicate with patient, insurance company and specialty referral provider as indicated.
• Maintain relationship and support communication standards with specialty referral providers.
• Navigate internal and external referral systems and be the primary point of contact for patients and families.
• Assume advocate role on the patient’s behalf with the insurer to ensure approval of necessary services in a timely fashion.
• Ensure the documentation of patient care in EPIC and follow workflows to meet patient engagement standards.
• Respond to the Referrals-workgroup line in a courteous and professional manner following La Clinica customer service and telephone standards.

Accountabilities

Responsible for closed loop-processing of specialty referrals including:

• Communication with patient, insurance company and specialty referral provider as indicated.
• Monitor referrals work queues daily for outgoing referrals and prioritize based on the referral priority set by the ordering provider.
• Request prior authorization following the patient’s specific insurance plan’s requirements.
• Submit referral requisition and supporting documentation to the specialty provider’s office.
• Follow up on referral requests that are pending a specialty consultation report.
• Inform ordering provider if patient declines, cancels, or fails to show to an appointment.

Required Education and/or Experience

• High school diploma or general education degree (GED)
• Excellent interpersonal communication and problem-solving skills
• Skilled at using electronic health records as applicable to area of work (EPIC)
• Bilingual in English and Spanish

Skills

• Intervene and promote reconciliation, compromise and positive outcomes in difficult interactions
• Medical terminology
• One year of work experience in medical office setting

Preferred

• Skilled at using electronic health records as applicable to area of work (EPIC)

Benefits

We extend our commitment to compassionate care to our employees as well. We invest in our employees' lives through competitive pay, comprehensive benefits packages, easy access to wellness, personal and professional development workshops, and a focus on healthy work-life harmony.