Referrals Assistant

TITLE: REFERRALS ASSISTANT

DEPARTMENT: FISCAL

SUPERVISED BY: PRC MANAGER

CLASSIFICATION: FULL-TIME / NON-EXEMPT

POSITION SUMMARY: Assists the Referral Coordinator with processing medical/dental/behavioral health referrals for patients and contributes as an integral part of the PRC department.

ESSENTIAL JOB FUNCTIONS:

• Gathers information/medical records for referral M.D.’s and mails or faxes the information.
• Schedules transport for patient if needed for the referral appointment.
• Schedules for referral appointments as needed.
• Maintains a Vendor/Provider file with information including vendors/providers, specialty, location, and different insurances accepted by them.
• Obtains insurance preapprovals on procedures, RAF’s and Treatment Authorization Requests from MediCal, CMSP and private insurance.
• Sends confirmation notices for referral appointments.
• Enters medical referrals on RCIS referrals program.
• Maintains followup logs for referrals and consultations.
• Obtains PRC authorization or denial on every referral and gives a copy of authorized referral to PRC personnel.
• Collaborates with Administration (PRC) to effect ongoing improvements in services.
• Performs related tasks as directed.
• Create monthly reports to present at the PRC monthly meetings with the Board of Directors.

EDUCATION, EXPERIENCE, CERTIFICATIONS AND LICENSES:

• High School graduate or GED. Relevant college courses preferred.
• Certified Nurse’s Assistant Certificate preferred
• Ability to keep accurate records and ability to organize multiple tasks.
• Prior experience in an office practice or medical clinic.
• Ability to operate basic office equipment (i.e., fax machine, computer, copier, etc.).
• Excellent telephone/verbal communication and patient skills.
• Ability to analyze and interpret governmental regulations.
• Ability to define problems, collect data, establish facts and draw valid conclusions.
• Work independently, be organized, flexible and prioritize responsibilities maintaining a calm productive atmosphere.
• Ability to interact professionally with patients and providers.
• Ability to interpret data about patients’ status in order to identify each patient’s age specific needs and requirements.
• Cooperate with other personnel to achieve departmental objectives and maintain good employee relations.
• Valid California Driver’s License with satisfactory driving record.

All LCTHC employees are expected to:

• Provide the highest possible level of service to clients;
• Promote teamwork and cooperative effort among employees;
• Maintain safe practices; and
• Abide by the LCTHC policies and procedures as they may from time to time be updated.

PHYSICAL DEMANDS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

Sitting / Mobility: Approximately 70% of time is spent working at a desk. Balance of time (approximately 30%) is spent moving around work areas.

Communication: Ability to effectively communicate with co-workers, Board members, members of outside agencies, in person, by telephone, and by email.

Vision: Ability to effectively use a computer screen and interpret printed materials, memos, and other appropriate paperwork. Lifting / Carrying: Ability to occasionally lift and/or move objects weighing no more than 25 pounds. Stooping / Kneeling: Ability to access files/stock supplies in low cabinets and shelves. Reaching / Handling: Ability to input information into computer systems and retrieve and work with appropriate paperwork, equipment, and supplies. Use of standard office equipment, including computer, telephone, calculator, copiers, and fax. Work is performed in an office/clinic environment, continuous contact with other staff and the public.

INDIAN PREFERENCE: Preference may be given to qualified Native American Indians according to the Indian Preference Hiring Act, CFR 25 USC 472. Other than Indian Preference, Lake County Tribal Health Consortium, Inc. adheres to all provisions of the Equal Employment Opportunities Act.

NOTICE OF DRUG-FREE WORKPLACE ACT REQUIREMENT: LCTHC is committed to maintaining a drug free and alcohol free workplace. LCTHC believes that a healthy, productive workforce free from the effects of drugs is very important to all employees and patients. Substance abuse is incompatible with the health, safety, efficiency and the success of LCTHC. Employees who are under the influence compromise LCTHC’S interests, endanger their own and the health and safety of others and can cause a number of other work-related problems. As a condition of employment, each applicant receiving a job offer from LCTHC must take and pass a required drug screen test.

HIPAA Health Insurance Portability and Accountability: This act was enacted to deal with three main areas with regard to patient information.

• Security of health information
• Standards of electronic transactions
• Privacy of individually identifiable health information

IMPORTANT DISCLAIMER NOTICE

The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

Lake County Tribal Health is an At-Will Employer. Either the employee or LCTHC can terminate the employment at will, without advance notice, at any time, with or without cause.