Referral Associate

Located in beautiful Northern California, Adventist Health Clear Lake has been a leading healthcare provider in Lake County since 1968. We are comprised of a 25-bed critical access hospital and provide primary and specialty care services at clinics throughout the area to best serve our community. Lake County is home to Clear Lake, California's largest natural freshwater lake, surrounded by charming small towns, beautiful mountains, vineyards and orchards. This area is perfect for outdoor enthusiasts, with some of the best bass fishing, rural trails for hiking and biking, all the while being only two hours from the San Francisco Bay Area, Sacramento Valley or Pacific Coast. Job Summary: Coordinates and completes referrals within the Hospital-based Outpatient Clinics (HBOC) including acquiring and verifying third party information, obtaining and arranging appointments and tracking. Works on routine assignments within defined parameters, established guidelines and precedents. Follows established procedures and receives daily instructions on work. Job Requirements: Education and Work Experience: High School Education/GED or equivalent: Preferred Associate's/Technical Degree or equivalent combination of education/related experience: Preferred Licenses/Certifications: Certified Nurse's Assistant (CNA), Medical Assistant (MA), or medical terminology course: Preferred Essential Functions: Communicates with ordering providers and nursing regarding insurance authorizations, denials, peer-to-peer review requests and scheduling difficulties with referrals to providers. Takes telephone requests for authorizations. Prepares referral requests. Informs patients of appointment information and instructions. Maintains electronic health record (EHR) referral documentation to reflect actions on specific referrals (including adding incoming referrals that were not generated from the electronic health record (HER . Maintains referral resource document. Schedules referral appointments with appropriate department or referred to provider. Tracks referral patient compliance and communicate with referring provider as necessary regarding patients refusing service and patients not showing up to a referral appointment. Submits retroactive authorization requests as needed. Performs other job-related duties as assigned. Organizational Requirements: Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations, including, but not limited to, measles, mumps, flu (based on the seasonal availability of the flu vaccine typically during October-March each year), COVID-19 vaccine (required in CA, HI and OR) etc., as a condition of employment, and annually thereafter. Medical and religious exemptions may apply.