Referrals Clerk (Case Mgmt) Bilingual Eng/Span for Community Clinic

Our award-winning community health center in Escondido is in need of a Referrals and Authorization Clerk (Case Management) full time.


**North County/local candidates highly preferred.**


Previous experience in healthcare field required. Knowledge of medical terminology and BILINGUAL ENGLISH/SPANISH REQUIRED.

Good computer skills a must. High school diploma/GED required.





**SUBMIT RESUME and COVER LETTER to laraineb@nhcare.org. Please reference "Referrals Clerk" in your subject line.**





You may also fax resumes to 760-737-7898 "Attn: Referrals Clerk Opening".





The detailed job description is as follows:





Summary: Under direction of the Site Supervisor and working closely with the providers at clinics, the Referrals & Authorization Clerk is responsible for the coordination of all patient referrals and follow-up care for the clinic patients.





Essential Duties/Responsibilities:


1. Responsible for completing the referral process including:


• Obtain referral from provider in timely manner


• Obtain authorization where applicable


• Schedule appointments


• Communicate appointment information to patient/family


• Communicate referral/authorization information and pertinent medical information to the specialty provider


• Follow-up with the patient and specialty provider to document that patient has kept appointment


• Obtain the consult/progress reports from the specialty provider, radiologist, etc.


• Appropriate documentation in the patient medical records


2. Track all referrals in the designated logs


3. Document all actions taken in the patient medical record in accordance with


current Clinic, DHS and Health Plan regulations/guidelines


4. Meet or discuss with patients any and all aspects of the referral process as needed or requested by the treating provider. This may include counseling the patient regarding the cost of a referral under provider direction.


5. Patient communication in person, by telephone and/or by mail.


6. Maintain accurate lists of specialists/providers by funding source and other community resources as approved by the Medical Director and/or supervisor.


7. Act as liaison between patient, clinic/providers, specialty care providers, health plans/funding sources and community resources.


8. Assist and actively participate with the CDP Cancer Detection Program, including maintaining the CDP log and completing all follow-ups for the clinic.


9. Maintain the CHDP log with follow-ups and applicable letters. Assure that copies of the log and applicable letters are sent to the country and state on a quarterly basis as dictated by CHDP.


10. Attend Health Plan Case Management operation meetings and MSO UM meetings on a rotating basis.


11. Other duties as assigned.





Customer Relations:


1. Respond promptly and with caring actions to patients and employees. Acknowledge psychosocial, spiritual and cultural beliefs and honor these beliefs.


2. Maintain professional working relationships with all levels of staff, clients and the public.


3. Be part of a team and cooperate in accomplishing department goals and objectives





HIPAA/Compliance:


1. Maintain privacy of all patient, employee and volunteer information and access such information only on a need to know basis for business purposes.


2. Comply with all regulations regarding corporate integrity and security obligations. Report unethical;, fraudulent or unlawful behavior or activity.





Qualifications:


Knowledge of medical terminology, computer skills including familiarity with spreadsheets and databases, bilingual (English/Spanish) required, strong communication and organizational skills, ability to interact effectively with clinic personnel, patients and outside





Education: High School diploma/ GED





Experience: Previous experience in health related field required.





Acknowledgement:


Neighborhood Healthcare is an Equal Opportunity Employer. We encourage applications from all individuals regardless of race, religion, color, sex, pregnancy, national origin, sexual orientation, ancestry, age, marital status, physical or mental disability or any other protected class, political affiliation or belief.











Skills/ Requirements





Important Notes Bilingual English/Spanish required.