Title: Referral Coordinator

Location: Fountain Valley, CA

Department: Ambulatory Care-Business Ctr

Status: Per Diem

Shift: Days (8hr)

Pay Rate*: $26/hr

MemorialCare is a nonprofit integrated health system that includes four leading hospitals, award-winning medical groups – consisting of over 200 sites of care, and more than 2,000 physicians throughout Orange and Los Angeles Counties. We are committed to increasing access to patient-centric, affordable, and high-quality healthcare; your personal contributions are integral to MemorialCare's recognition as a market leader and innovator in value-based and other care models.

Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration, and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation, and teamwork.

Position Summary

Creates and assists with the preparation of referral requests.As part of the preparation process will verify eligibility, benefits, request any needed clinical notes and accurately complete or forward referral to appropriate staff to finalize decision. Ensures that all referral policies and procedures are followed as required to meet all contractual, regulatory and federal requirements

Essential Functions and Responsibilities of the Job

1. Research and process incoming referral requests and CRM’s received via fax or system generated

2. Check HP eligibility and benefits as needed

3. Gather clinical notes and HP criteria as needed

4. Scan and attach faxed clinical information

5. Demonstrate good problem-solving skills

6. Provide a high standard of customer service for Patients, Physicians and Staff

7. Demonstrate professional and courteous communication skills.Supports a collaborative and cooperative environment when working with others to facilitate mutual respect and effective interpersonal relations.

8. Meet all department standards

9. Responsible for running daily reports to capture all work stream referrals including; urgent referrals, ASA referrals, portal referrals and indemnity/PPO submissions, ODAG reports and other requested ad hoc reports for utilization, productivity and operational metrics.

10. Assist providers, patients, other departments regarding referral questions and urgent referral coordination

11. Ability to be at work on time

12. Ability to follow company policies, procedures and directives

13. Ability to interact in a positive and constructive manner

14. Ability to prioritize and multitask with attention to detail and timeliness for task completion

15. Perform any additional duties that may not be inclusive in job description as requested by Management team that is within the scope of knowledge or ability of the Referral Coordinator.

16. Telecommuting (full or part time) based on business necessity, functional area, productivity measures and availability of resources.Administration of this option will be in line with Telecommuting Policy, Reference # HR344.”

17. Able to travel to other clinics to cover staffing needs and training as directed by management

*Placement in the pay range is based on multiple factors including, but not limited to, relevant years of experience and qualifications. In addition to base pay, there may be additional compensation available for this role, including but not limited to, shift differentials, extra shift incentives, and bonus opportunities. Health and wellness is our passion at MemorialCare—that includes taking good care of employees and their dependents. We offer high quality health insurance plan options, so you can select the best choice for your family. And there’s more...Check out our MemorialCare Benefits for more information about our Benefits and Rewards.

Minimum Requirements

Qualifications/Work Experience:

• Experience in Managed Care or Medical Field 1-2 years preferred.

• Working knowledge of medical terminology, able to interpret health plan benefit manuals, CPT/ICD coding is preferred.

• Type with speed and accuracy, 40 - 50 wpm.

• Must have excellent computer skills.

• Excellent customer service skills and be a team player.

• Must be dependable.

• High degree of organizational skills.

Education/Licensure/Certification:

• Must be a High School Graduate/ or G.E.D or equivalent.

• Medical terminology, preferred.