REFERRAL SPECIALIST I Details

REFERRAL SPECIALIST I

Family Health Centers of San Diego - San Diego, CA

Employment Type : Full-Time

For nearly 50 years, Family Health Centers of San Diego (FHCSD) has provided affordable, high-quality health care and supportive services to all San Diegans. With more than 1,800 employees spread throughout 40 sites around the county, FHCSD is proud of the diversity of its staff as a reflection of the communities it serves.

The reward of working at FHCSD is more than a paycheck and excellent benefits; it is the impact and contribution to the San Diego community that employees value most. If you are passionate about improving the overall health and livelihood of your community, FHCSD is looking for people like you.

Family Health Centers of San Diego (FHCSD) is looking for a Referral Specialist. The Referral Specialist coordinates, processes and documents medical referrals and prior authorizations for a variety of medical services for clinic patients, as requested electronically by clinic providers. This requires clinical knowledge and understanding of CPT and ICD-9(10) codes to meet the requirements of third party payers and specialty clinics to ensure minimal delay in securing referral appointments or pre-authorizations. As an integral member of the Health Care Team, the Referral Specialist manages a high volume of referrals and pre-authorizations for multiple Providers and collaborates with other Clinic Referral Specialists, Providers, MA's, Patient Service Representatives and other support staff in multiple clinic locations. This position requires the use of clinical and administrative judgment and initiative to determine best approach for both urgent and non-urgent patient care needs.

Responsibilities:

• Completes all required documentation accurately, in a timely manner, and thoroughly in accordance with department standards; in addition, documentation complies with patients' insurance requirements.
• Meets daily referral modification productivity standards for Referral Specialists, adhering to referral processes and guidelines.
• Per referral guidelines, provide appropriate clinical information to specialist.
• Performs other duties as assigned.
• Prepares and processes all referral and pre-authorization paperwork, including gatherings pertinent information as needed via EHR, from incoming phone/email/fax messages, or from clinical team. Contacts various clinics, facilities, and companies to obtain information to accurately complete referral/pre-authorization requests.

Requirements:

• At least 1 year of experience in ambulatory care setting or similar setting is strongly preferred.
• High school diploma or GED equivalent required.
• Medical Terminology Course required, or able to complete within 90 days of hire.

Rewards:

• Job type: Regular Full Time
• Competitive Salary with Excellent Benefits
• Retirement Plan with Employer Match
• Paid Time Off, Extended Sick Leave and Paid Holidays
• Medical/Dental/Vision/FSA/Life Insurance
• Employee Discounts and Wellness Programs
• Sponsoring Employer with an Equity Investment Company that can assist you with your down payment for purchasing a home

FHCSD was founded by community activists working towards a common goal: caring, affordable, high-quality medical care for all. We are proud to continue this mission today as we provide accessible services to over 210,000 patients across San Diego County. The successful candidate will have a demonstrated commitment to community medicine and providing culturally competent care to the medically underserved.