Referral Clerk

  • Fresno
Job Summary:      The person in this position is part of the team concept in the Center’s health delivery system, which is devoted to coordinate all patient referrals and refills at the request of the providers. The function including coordinating the referrals/refills with patients as well as tracking any reports as they are received. Responsible to ensure that patients will receive timely, high quality and efficient specialty care and support services through the referral system. Must be familiar with community resources to facilitate the needed services for patients at Omni Family Health. Job Duties:
  1. Shall efficiently coordinate all patients’ referrals at the request of the providers.
  2. Shall efficiently process any patient refills request and enter the information in EHR.
  3. Shall appropriately schedule and or cancel all appointments, coordinating with the patients and the outside providers.
  4. Shall appropriately determine and validate patient eligibility, validate patient demographic information and pull records and file documentation.
  5. Shall efficiently notify the patient of said appointment or refills status and give any instructions if needed.
  6. Advocate for patient discounts with local vendors, including hospitals, laboratories and individual medical providers especially for sliding fee scale and self pay patients.
  7. Prepare Treatment Authorization Request (TARs) and any other authorizations necessary for outside patient care, and health plan payment.
  8. Shall proficiently track and record reports in the referral systems and electronic health record as they are received.
  9. Follow-up on pending referrals to include sending certified letters to non-compliant patients.
  10. Shall cooperatively work with outside agencies to help patients apply for alternate resources when appropriate.
  11. Manage and follow up on tracking system for immunizations, pap smears, and mammogram.
  12. Other related duties or responsibilities as assigned.
  13. Promotes and believes in OFH mission statement .
  14. Ability to relate to the public regardless of racial, ethnic and economic status.
Additional Duties:
  1. HIPAA compliance - Responsible for maintaining abreast of and in compliance with all HIPAA regulations and requirements. Treats all member information confidential.
  2. Compliance - Ensure compliance with all local, state and federal regulations.
  3. QA/QI - Participate in QA/QI activities and contribute towards the overall performance improvement of the organization.
  4. IT – Required to learn and use the Electronic Health Record and Practice Electronic System and its components. As required by the job functions and highlighted in the Policies and Procedures. These components include Next Gen, PMS, QSI and other electronic features, as they are developed and implemented, as applicable to work environment.
  5. All employees will participate in Patient Centered Health Home Model at Omni Family Health.
Qualifications, Education, and Experience:
  1. Must have thorough education or training in the basics of medical assisting. A minimum of one year experience as a medical assistant required.
  2. High school diploma or equivalent
  3. Bilingual in English/Spanish preferred.
  4. Ability to work with clinical staff and handle pressure from more than one provider.
  5. Commitment to the concepts of preventive health cares program and team approach to health care delivery.
  6. Ability to learn about patients and their problems.
  7. Ability to learn about patients and their problems
Responsible To:         Referral Supervisor Classification:            Full Time Position, Non-Exempt