Referral Associate - Outpatient, AHHF AHPN Call Center (Full-Time, Day Shift)

Located in a tight-knit community in Kings County, Adventist Health Hanford has been serving the Central Valley since 1965. We are comprised of a 173-bed hospital and many outpatient clinics with primary and specialty care services. Hanford residents are proud of their city's historic charm and family-friendly atmosphere. Within an hour's travel time, Yosemite, Sequoia and Kings Canyon National Parks can be enjoyed. 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.

FLSA Status:

Non-Exempt 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 Skills, Knowledge and Abilities:

• Refer to Job Analysis 05B for details regarding additional ability requirements.

Organizational Requirements:

Adheres to the Adventist Health Mission, Vision and Values statements. Complies with behavioral standards, policies, procedures and handbooks established by the organization and their respective ministries. Abides by the guiding principles of the Code of Conduct Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply. Adventist Health participates in E-Verify.

Visit https:

//adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.

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.