Referral Associate (Outpatient), AHBD (Full-Time, Day Shift)

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

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.

This role will support clinic operations by coordinating appointments, processing medication refill requests, and managing verification inquiries in a non-patient-facing environment.

Organizational Requirements:

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.