Under the direction of the Referral Coordinator, the position assists patients with referral needs and to connect patient services with outside resources.
Essential Duties and Responsibilities
- Process referrals for insured and uninsured patients throughout Los Angeles County utilizing Medpoint System for insured patients and the Referral Processing System (RPS) and eConsult for uninsured patients. And uninsured patients for mammography will be referred to in-house service provided by outside agency. Process referrals with private insurances HMO and PPO.
- Verify patient insurance status whether patient have insurance or not. If patient is insured, check eligibility to determine specialist’s resource. If patient is uninsured, chose public resource.
- Refer for in-house service such as retinal screening and telederm for uninsured patient.
- Communicate daily with Health Care LA IPA, RPS system and eCounsult to check status.
- Upon approval for referral request, notice to patient appropriately such as phone and mail. And send necessary document to specialist by fax.
- Request report from specialists and the report will be scanned into eCW and assigned to appropriate physician. For mammogram and retinal screening, patient will be referred to specialist for necessary treatment according to the report.
- Each referral clerk documents all the process in ecw until we receive the report. And record necessary information to keep track on referral status on our own.
- Attend monthly meetings addressing utilization management for Health Care LA IPA , eConsult and RPS system. (for designated staff only)
- Responsible for a monthly report to measure productivity.
- Other duties as assigned.
The physical demands are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to sit and talk or hear. The employee is occasionally required to stand; use hands to handle or feel objects, tools, keyboard, or controls; and reach with hands and arms. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
Job Description Disclaimer
This position requires compliance with Health Center’s written standards, including its Standards of Conduct and policies and procedures ("Written Standards"). Such compliance will be an element considered as part of the Referral Clerk’s regular performance evaluation.
Failure to comply with Health Center’s Written Standards, which may include the failure to report any conduct or event that potentially violates legal or compliance requirements or Health Center’s Written Standards, will be met by the enforcement of disciplinary action, up to and including possible termination, in accordance with Health Center’s Compliance Program Policy and Procedure.
I have reviewed and understand the job functions required of me for the position in employment with T.H.E. Health and Wellness Centers. I understand that T.H.E. Health and Wellness Centers reserves the right to modify job duties or job descriptions at any time.