Specialty Referrals Clerk

Specialty Referrals Clerk Full Time | Hourly Center for Learning and Innovation We’re committed to compassionate care for all.
Our patients.
Our employees.
You.
At La Clinica, we love our patients and enthusiastically treat them with the same care, respect, and dignity that we would our friends, family, and neighbors because that's who they are.
If this appeals to you, La Clinica might be the right place to build your career.
We’re looking for the right team members to treat our patients with this level of care.
We extend our commitment to compassionate care to our employees as well.
We invest in our employees' lives through competitive pay, comprehensive benefits packages, easy access to wellness, personal and professional development workshops, and a focus on healthy work-life harmony.
Check out our careers page to learn more about why our employees love working at La Clinica.
Specialty Referral Clerk will screen and support patient in connecting with specialty offices base on medical provider referral.
Accountabilities Include: Performs Essential Job Duties Responsible for closed loop-processing of specialty referrals including: communication with patient, insurance company and specialty referral provider as indicated.
Monitor referrals work queues daily for outgoing referrals and prioritize based on the referral priority set by the ordering provider.
As required, request prior authorization, following the patient’s specific insurance plan’s requirement.
Submit referral requisition and supporting documentation to the specialty provider’s office.
Follow up on referral requests that are pending a specialty consultation report Inform ordering provider if patient declines, cancels, or fails to show to an appointment.
Maintains relationship and supports communication standards with specialty referral providers.
Navigates internal, and external referral systems and is primary point of contact for patients and families.
May assume advocate role on the patient’s behalf with the insurer to ensure approval of the necessary services for the patient in a timely fashion.
Ensures the documentation of patient care in EPIC and is responsible for following workflows that result in capturing activities to meet patient engagement standards as outlined in the APCM program.
-CareSTEP: Online Portal Engagement -CareStep: Health and Wellness Call -CareSTEP: Care Gap Outreach -CareSTEP: Coordinating Care-Transitions of Care CareSTEP: Coordinating Care-Dental -CareSTEP: Accessing Community Resources -CareSTEP: Transportation assistance Responds to the Referrals-workgroup line in a courteous and professional manner following La Clinica customer service and telephone standards.
Additional Duties: Completes assigned trainings via La Clinica’s learning module system (Relias) by required due date.
Other duties as assigned Customer Service: Develops and maintains professional, support-oriented working relationships with patients, employees, team members, and community partners.
Demonstrates continuous improvement in achieving “developing” and “fully competent” levels of La Clinica’s Behavioral Standards.
Follow La Clinica’s SERVE standards and they are the following: Service: I provide, helpful service focused on the needs of others.
Empathy: I welcome and connect with you on a personal level.
Relationships: I create partnerships, working a way that benefits everyone.
Value: I recognize the importance of others and treat everyone with respect.
Excellence: I go above and beyond to deliver an exceptional experience.
Qualifications: Must be able to interact with a variety of individuals at various levels under stressful circumstances while exercising sound judgement, tact, and diplomacy; work productively both independently and in a team setting; communicate with clarity, both verbally and in writing to groups and individuals, be an exceptional listener, and be flexible and adaptable within a fast-paced primary care setting.
Education and/or Experience: Required: High school diploma or general education degree (GED) Excellent interpersonal communication and problem-solving skills Skills to intervene and promote reconciliation, compromise and positive outcomes in difficult interactions Preferred: Medical terminology One year of work experience in medical office setting Skilled at using electronic health records as applicable to area of work (EPIC) Language Skills: Must have the ability to communicate with clarity, both verbally and in writing; read, analyze, and interpret complex documents, regulations, policies, and procedure manuals; and create professional business documents.
Preferred bilingual English/Spanish.
Mathematical Skills: Must have the ability to add; subtract; multiply; use percentages, fractions, decimals; interpret numeric graphs; and apply basic algebra, geometry, and statistics.
Reasoning Ability: Must have the ability to: Understand confidential document security from a legal perspective Effectively deal with a variety of abstract and concrete variables Physical Demands: The physical demands described here are representative of those that must be met by a Specialty Referral Clerk to successfully perform the essential functions of this job.
Reasonable accommodations may be made to enable those with disabilities to perform the essential functions.
Equity Statement: At La Clinica, we commit to engage everyone in a welcoming, respectful, and loving way and to maintain the dignity and value of all people above everything else.
These standards align with our organization’s vision of absolute excellence, open-hearted community, and well-being for all.
For more information, please visit our website at: https://laclinicahealth.
org/patients/approach/ Applications will be reviewed by the appropriate Department for interview; those selected must be able to provide proof of legal right to work in this country.
La Clinica is a drug free work environment, Equal Opportunity Employer.
La Clinica complies with the Americans with Disabilities Act.
If you consider yourself disabled and desire assistance in the application process, please contact the Human Resources Department.