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Referral Coordinator

Remote: 
Full Remote
Contract: 
Full time
Experience: 
Mid-level (2-5 years)
Work from: 
Canada

Offer summary

Qualifications:

Minimum 2 years of referral experience, High School Diploma required, Certified Medical Assistant preferred.

Key responsabilities:

  • Process and manage referral requests.
  • Maintain accuracy in IDX documentation.
  • Manage daily production based on standards.
  • Respond to voice mails within 24 hours.
  • Assist with special projects and duties.
Prospect Medical Systems logo
Prospect Medical Systems SME https://prospectmedicalsystems.com/
501 - 1000 Employees
About Prospect Medical Systems
With approximately 9,000 physicians to serve our 260,000 members, Prospect Medical Systems is proud to be among the most innovative medical systems in California, Texas and Rhode Island. In the months and years ahead, we will be offering our services in other states and other markets throughout the nation. Our extensive care services range from primary care and specialty physician services to acute care hospital and skilled nursing facilities to behavioral health and wellness services. Each of our Independent Physician Associations (IPAs) and networks support the use of advanced diagnostic and treatment tools to provide our members with convenient access to state-of-the-art healthcare. Our pledge to members is that we will give you exceptional care delivered by compassionate physicians who have a strong commitment to each and every patient. Our physicians work closely with teams of skilled nurses and other healthcare professionals. Prospect Medical contracts with most major health plans, and we serve all product lines, including Commercial, Medicare, Medicaid, Medicare/Medicaid (Medi-Medi) and Health Insurance Exchange. To further improve the health of the communities we serve, Prospect Medical offers comprehensive health education classes and support services through our numerous outreach programs. Diversity and Inclusion Within Our Workforce At Prospect Medical, we believe that a diverse and inclusive environment enriches our workforce and the communities we serve. To that end, we embrace the diversity of our coworkers, physicians, vendors and patients. We do not tolerate harassment or discrimination on the basis of race, ethnicity, religion, gender, sexual orientation, gender identity or expression, national origin, age, disability, veteran status or any other characteristics protected by law. We embrace diversity because it is our culture, and it is the right thing to do.
See more Prospect Medical Systems offers

Job description

Job Description

The Referral Coordinator prepares referrals and address stat line requests. Complete daily tasks/queues as assigned. Assist the Referral Nurse and Medical Directors daily with additional information needed for completion. Document pertinent information in Aerial Comments and IDX referral system. Special projects as assigned.

Responsibilities

Process referral requests received and assigned referral queue using Auto Approval List. Pend nurse and Medical Director review to appropriate referral requests timely to ensure compliance is maintained. Complete daily referral assignments received by fax, phone or portal etc.|Documents all pertinent information in IDX to include medical notes, benefit information, contracted vs non contracted provider. Accurate data entry into IDX fields.|Maintain timeliness standards by regulatory requirement for each product line.|Maintain daily production standard based on corresponding assigned job duties set by department manager. Handle stat calls for assigned team on a daily basis and adhere to department standards for coverage. Answers all voice mail at least every hour and respond to messages within 24 hours to ensure customer satisfaction is maintained. Alert Nurse Reviewer of expedited requests.|Provide notifications to providers and members within 24-72 hours or by regulatory requirements. Assist providers, patients and internal and external customers regarding issues related to referrals. Special projects as assigned which may include CCS, OIG, Unused/Expired, Fax Failure, IHA, NOMNC etc. 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.

Qualifications

Minimum of two (2) years of experience with Referral Healthplan, IPA or Medical Provider office with referral management and/or call center knowledge.High School Diploma required. Certified Medical Assistant preferred.

"Location-Based Pay Adjustment"

Required profile

Experience

Level of experience: Mid-level (2-5 years)
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Hard Skills

Data EntryDocument ManagementElectronic Referrals

Other Skills

  • Time Management
  • Customer Service
  • Verbal Communication Skills
  • Problem Solving
Are you interested?

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