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Medical Referral Clerk (Azusa Clinic)

Company: EL PROYECTO DEL BARRIO INC
Location: Azusa
Posted on: May 3, 2021

Job Description:

Job DetailsLevelUndisclosedJob LocationAzusa Health Center - CA, CARemote TypeN/APosition TypeUndisclosedEducation LevelUndisclosedSalary RangeUndisclosedTravel PercentageUndisclosedJob ShiftUndisclosedJob CategoryUndisclosedDescriptionRESPONSIBILITIES: This position reports to the Clinic Administrator. S/he will process all HMOs, Medi-Cal, Medicare and MHLA referrals. S/he will enter data to generate authorization numbers. Present prospective and retrospective referrals to the UR meeting. S/he will maintain required logs: prospective, retrospective, denial and etc. Submits required UM reports to the health plans in a timely fashion. Will coordinates with the Claims Adjudicator and Case Managers relating to patients referrals, claims or case management. Will coordinates with patients, Managed Care Dept., EPDB providers, specialists, hospitals and health plans on referral issues. S/he will assist providers and specialists with the referral process. Attends and actively participates in the UM meetings, in-services, and meetings requested by the Clinic Administrator. S/he will participate in and in the preparation of funding audits. Complies with EPDB UM/QM and health plans' policies and procedures. S/he will conduct in-service trainings at each clinic site regarding the referral process, assists the Clinic Administrator in developing the Annual and Evaluation UM Program. Generates and reviews patients' referral utilization reports. Will perform other assigned duties as requested.QualificationsREQUIREMENTS: Must possess good organization skills. Mature judgment, tact, discretion and confidentiality are mandatory. Proficient in Microsoft Word and Excel. Understanding of medical terminology, CPT codes and ICD10. Position requires a professional, pleasant and effective representation of the corporation. Bilingual (Spanish/English) preferred.OTHER REQUIREMENTS: Must submit to and pass a drug test and a criminal background clearance as a pre-condition for employment.QUALIFICATIONS: High School Diploma OR GED. Must have at least one (1) year clerical experience in a medical setting OR general office work. EL PROYECTO DEL BARRIO IS AN EQUAL OPPORTUNITY EMPLOYER

Keywords: EL PROYECTO DEL BARRIO INC, Azusa , Medical Referral Clerk (Azusa Clinic), Other , Azusa, California

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