Job: Referrals Specialist

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Jobing Description

Since 1969, San Ysidro Health Center (SYHC) has been providing quality, low-cost, primary health care services to South Bay & Central/Southeastern San Diego residents. SYHC offers an extensive array of family-oriented primary health care services, including pediatrics, obstetrics and gynecology, adult medicine, dental care, mental health, podiatry, radiology, laboratory, and pharmacy. We encourage all patients to actively participate in promoting and protecting their own health. Toward this goal, SYHC offers a variety of free health education programs.

SYHC is dedicated to providing excellence in health care services and programs for all people of all ages - from infants to seniors. We are currently recruiting a temporary Referrals Specialist at our main San Ysidro Heatlh Center Clinic.

Responsible for timely processing, documenting, scheduling and follow up of referrals and request for treatment authorizations as requested by the primary physician.

Essential Functions of the Job:


1. Receives and processes authorizations on timely manner. Schedules all requests for referrals and treatment authorizations.


2. Obtains authorizations from various insurance carriers via phone, in writing or electronic media.


3. Schedules appointment for specialty care, special studies or other ancillary services as requested by the primary care physician.


4. Coordinates care within the guidelines of multiple health plans, contracts or insurance types.


5. Responds to inquiries as to current status of authorization by assessing the request and evaluating the circumstances to provide the correct information.


6. Initiates the appropriate documentation of requests from specialties offices for ongoing care.


7. Follows-up on missing documentation to obtain authorization or scheduling when appropriate.


8. Uses various modules of the computer system to obtain information, schedule appointments, query information and obtain authorizations.

Skills / Requirements

Education: High school diploma and Medical Terminology and ICD-9, CPT coding or Medical Assistant.
Certifications/Licenses Required: Medical Terminology, CPC or Medical Assistant Certificate.
Bilingual (English/Spanish).
Experience: 2 years experience in medical field to include front office and appointment scheduling or referral authorization knowledge of programs and health plans eligibility and guidelines, coding and data processing. Good typing skills required.

To apply please submit resume to jobs@syhc.org.