- Full Time/Contract
- Utilization Management
- Fountain Valley, CA
Our client is a is a nonprofit integrated delivery system that includes multiple top hospitals, health plans and freestanding ambulatory surgery centers in Orange and Los Angeles Counties. An innovator in healthcare delivery, our client focuses on evidence-based, best practice medicine and has gained widespread recognition for their approach in healthcare.
POSITION TITLE & LOCATION
Referral Coordinator – Fountain Valley
- Research and process incoming referral requests received via fax or system generated
- Check Client eligibility and benefits as needed
- Gather clinical notes and Client criteria as needed
- Scan and attach faxed clinical information
- Demonstrate good problem-solving skills
- Provide a high standard of customer service for Patients, Physicians and Staff
- Demonstrate professional and courteous communication skills. Supports a collaborative and cooperative environment when working with others to facilitate mutual respect and effective interpersonal relations.
- Responsible for running daily reports to capture all work stream referrals including; urgent/emergent referrals, ASA referrals, portal referrals and indemnity/PPO submissions, ODAG reports, inpatient daily census/authorization logs if work location is inpatient related, and other requested ad hoc reports for utilization, productivity and operational metrics.
- Assist providers, patients, other departments regarding issues related to referrals
- Responsible for the coordination of PCC meetings, by preparing agenda, roster, distribution of reports, food orders, scheduling guests, scheduling meeting time and room preparation if work location is at clinic site.
QUALIFICATIONS / REQUIREMENTS
- Experience in Managed Care or Medical Field 1-2 years preferred. Familiarity with the interpretation of health plan benefit manuals and CPT/ICD coding, preferred.
- Type with speed and accuracy, 40 – 50 wpm.
- Must have excellent computer skills.
- Excellent customer service skills and be a team player.
Monday – Friday (8a or 8:30 – 5pm) 3 month Contract Temp (Must be able to work until 5pm)