Referral Specialist

For more than 55 years, Family Health Centers of San Diego's (FHCSD) mission has been to provide caring, affordable, high-quality health care and supportive services to everyone, with a special commitment to uninsured, low-income and medically underserved persons.

FHCSD is one of the top 10 largest federally qualified health centers (FQHCs) in the country. We operate more than 90 sites across San Diego County, including 29 primary care clinics, 23 behavioral health facilities, 10 physical rehabilitation clinics, nine dental clinics, five vision clinics, four outpatient substance use treatment programs, three mobile medical units, two mobile counseling centers, two urgent care centers, and a pharmacy.

Our staff provides care to over 227,000 patients each year, of whom 91% are low-income and 29% are uninsured. FHCSD provides care to all. Services include, but are not limited to adult care, chronic disease management, pediatrics, comprehensive women's care including obstetrics, dental, vision, case management, physical rehabilitation, speech therapy for children, vaccinations, infectious diseases, behavioral health, substance use counseling and a host of specialty services including cardiology, podiatry, endocrinology, dermatology, among others. FHCSD also offers supportive services to those who are unsheltered and in need of intensive case management.

The breadth of our clinic locations, services and programs has grown over the last five decades, making us the largest community clinic provider of health care to the uninsured in the county and one of the top 10 largest community clinic organizations in the nation. We are also the largest health care safety-net provider, largest school-based health care provider and the largest mental health provider in the San Diego region.

Family Health Centers of San Diego is looking for a Referral Specialist to coordinates, processes and documents medical referrals and prior authorizations for a variety of medical services for clinic patients, as requested electronically by clinic providers. As they serve as the liaison between our clinics and specialist offices, they encompass excellent patient-centered communication, educational knowledge of the referrals process, and use both clinical and administrative judgement to determine the best approach for both urgent and non-urgent patient care needs.

Responsibilities:

• Provides communication to clinical staff regarding the status of pending referrals and status changes.

• Contacts various clinics, facilities, and companies to obtain information to accurately complete referral/pre-authorization requests.

• Actively tracks the referral pools and manages follow-ups in a timely manner.

• Enters required data which includes insurance, screening information, and fee information (if applicable).

• Completes all required documentation with accuracy according to established department protocols including the ICD-9 and CPT codes.

• Basic Knowledge of medical terminology, insurance, and administrative/computer skills.

• Completes all required documentation with accuracy according to established department protocols including the ICD-9 and CPT codes.

• Manages time effectively and can multi-task.

• Performs other duties as assigned.

Requirements:

• High school diploma or GED equivalent required.

• Medical Terminology Course required, or able to complete within 90 days of hire.

• At least 1 year of experience in ambulatory care setting or similar setting is strongly preferred.

• Basic computer literacy (i.e., use system to manage and schedule appointments, access electronic medical record information).

• Basic organizational skills, attention to detail, time-management skills, and strong motivation to meet deadlines and achieve goals.

• Bilingual in Spanish/English preferred.

• Clinical knowledge of medical terminology, medical procedures, CPT, and ICD-9 (10).

• Intermediate knowledge of insurance providers, their portals and their expectations for authorization approval.

• Traveling between sites and other locations is occasionally required. Must have a valid California driver's license, an automobile, and proof of minimum levels of car insurance as required under California law, although limits of $100,000 are recommended. An acceptable driving record is also required. California law requires all drivers to obtain a valid California driver's license within ten days of establishing residency. Reasonable accommodation may be provided on a case-by-case basis. Mileage and other reimbursement governed by policy.

Rewards:

• Job type: Regular Full Time

• Competitive Salary with Excellent Benefits

• Retirement Plan with Employer Match

• Paid Time Off, Extended Sick Leave and Paid Holidays

• Medical/Dental/Vision/FSA/Life Insurance

• Employee Discounts and Wellness Programs

The successful candidate will have a demonstrated commitment to community medicine and providing culturally competent care to the medically underserved.

We are excited to share that the salary range for this position is:

$25.00 - $30.93

Information on our extensive benefits package can be found here: FHCSD Wellness - Employee Hub (gobenefits.net)

FHCSD provides Equal Employment Opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, transfer, leave of absence, compensation, and training.