Job Openings in Sacramento County and Beyond
Regional Referral Coordinator
Responsibilities: Provides personalized and effective customer service in the management of referrals for patients requiring specialty services from contracted medical groups, hospital systems, and third-party payors. Reviews confidential clinical information and determines if requested/required services are available within the organization through careful analysis combined with proficient knowledge of complex procedures, payor rules & regulations, specialist's capacity, professional interests and contractual relationships. Facilitates patient referrals to the appropriate facilities, programs, affiliated and aligned specialists. Creates smooth and efficient referral workflows for external sources, leveraging evolving technology and interoperability tools while reporting to the Program Manager, difficulties and/or challenges to gain relationships and exposure necessary.
Requirements: AA Degreeor Bachelor's Degree required (If not, 10+ years of experience in a similar capacity.) 3-5 years' experience in a hospital, physician office, or case management setting. 3-5 years of experience working with database systems and telephone call center required. 3-5 years previous insurance experience required. Ability to use good judgment. Ability to pass on boarding requirements - drug and background screening. Demonstrated longevity in prior roles.