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Position Summary:

The Referral Coordinator (REFC) reports to the Referrals Manager and provides clerical and administrative support to the health center for the organization of internal and external referrals. This position will support the daily needs of all of the Referral Coordination for the medical department in the health center. The REFC is responsible for ensuring that all appointments, required documentation, insurance information and prior authorizations are established with specialty providers, insurance entities and patients.

Essential Functions:

• Receives referral requests from providers and communicates with them, or a member of the patient’s care team, as needed

• Obtains prior authorizations for patient referrals to specialists and surgeries. Advises provider if authorization request is denied.

• Communicates with different insurance companies to process referrals appropriately and verifies eligibility of insurance for patients

• Requests appointments from appropriate specialty providers

• Verifies eligibility of insurance for patients

• Communicates with patients and informs them of referral status

• Requests consult notes once patient has been seen by specialist and closes referrals upon receipt.

• Communicates with Specialist regarding referral needs.

• Follows up on referrals with specialty providers and patients.

• Obtains ongoing knowledge, documentation, and updates of appropriate referral resources, required forms and key contact persons

• Reviews and assesses medical records for referral processing.

• Tracks and processes referral using NextGen Diagnostics and Referrals sections in the A/P section of the SOAP note.

• Prioritizes and processes referrals by urgency or PCP request.

• Completes referral data tracking for Quality Assurance programs.

• Complies with all state and federal laws and regulations, as they pertain to position including; HIPAA, sexual harassment, Scope of Practice, OSHA etc.

• Other duties as assigned.

Skills and Abilities:

+ Experience with NextGen EHR/PM software.

+ Knowledge of Medi-Cal, Medicare, and managed care plans

+ Knowledge of medical terminology and medical procedure terminology

+ Excellent computer skills, preferably with Windows, including Microsoft Office Suite

+ Must possess excellent organizational, writing, and verbal skills.

+ Ability to work independently, set priorities, and work well under pressure.

+ Ability to maintain a high degree of confidentiality

+ High School diploma or equivalent.

+ Minimum of 1 year of experience in referral coordination

+ Excellent computer and technology skills.

+ Ability to communicate orally and in writing; professional demeanor

Pay and Benefits

The pay range for this position is $22.00 - $24.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully onsite position in Sacramento,CA.

Application Deadline

This position is anticipated to close on May 7, 2025.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email [email protected] (%[email protected]) for other accommodation options.