Overview
The fundamental reason this classification exists is to ensure that CJMC patient with referral has access to other specialists or institution for additional health care services. The position requires the CJMC staff has a working knowledge of processing patient data and the managed care referral programs. Additionally, the CJMC staff is required to maintain patients’ confidentiality in regard to HIPAA and other federal, state and local regulations as stated in the CJMC policies and procedures manual.
Responsibilities
- Coordinates all patient referrals for Internal Medicine.
- Research patients managed care organization for proper providers.
- Educate patients about referral guidelines or policies.
- Obtain current identification for managed care, preparing certification as required.
- Preparing authorization with patient diagnosis and request from primary care physician.
- Schedule appointment for specialty services and request follow-up information.
- Maintains current knowledge of all managed care referral policies and implements procedural changes as required.
- Obtains and documents authorizations/pre-authorizations for patients’ clinical treatment.
- Other duties as assigned.
Qualifications
- Demonstrated ability to adapt to changes readily.
- Knowledge of administrative and clerical procedures.
- Ability to follow instructions, given either orally or in writing.
- Able to convey information effectively.
- Ability to work with little or no supervision.
- Demonstrate effective follow-through with all task.
- Able to manage one’s own time under tight time constrains.
- Maintain high level of confidentially.
- Ability to complete assignment in a timely manner.
- Working knowledge of CJMC policies and procedures.
- Able to work as a team player.
- The ability to speak Spanish
We are an Equal Opportunity Employer
