About The Role

Lying just inland between the State's coastal mountain ranges and the Sierra Nevada Mountains, Adventist Health Reedley has been serving the Central Valley since 2011. We are comprised of a 49-bed acute care hospital and 60 clinics in 27 rural communities with primary and specialty care services. Reedley is a perfect location for outdoor enthusiasts as it is located in the central San Joaquin Valley portion of California, close to Yosemite, Sequoia and Kings Canyon National Parks. In addition to the beautiful landscape, it also offers a great cost of living and close-knit communities.

Job Summary

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.

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

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.