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Eligibility and Referral Coordinator - Newport Beach, CA

Job Summary:

We are seeking a highly organized and detail-oriented Eligibility and Referral Coordinator to join our dynamic dermatology office team. The Eligibility and Referral Coordinator plays a crucial role in ensuring seamless coordination of patient referrals, promoting effective communication between healthcare providers, and enhancing the overall patient experience.

Essential Functions:

To perform this job, an individual must perform each essential function satisfactorily with or without a reasonable accommodation.

  1. Referral Processing:

    • Receive and review referral requests from both internal and external sources.
    • Verify referral information for accuracy and completeness.
    • Ensure all necessary documentation is included in the referral request.
  2. Communication:

    • Collaborate with referring healthcare providers to obtain additional information when needed.
    • Communicate with patients to provide information about the referral process and schedule appointments with specialists.
    • Maintain open lines of communication between our dermatology office and referring healthcare professionals.
  3. Documentation and Record Keeping:

    • Maintain accurate and up-to-date records of all referral activities.
    • Input referral information into the electronic health record (EHR) system.
    • Generate reports on referral status and outcomes for review by management.
  4. Insurance Verification:

    • Verify insurance coverage for referred services and communicate relevant information to patients.
    • Coordinate with the billing and insurance teams to address any pre-authorization requirements.
    • Navigate local IPA/HMO portals such as Optum, Hoag Physician Partners, Availity, and others efficiently.
  5. Appointment Scheduling:

    • Schedule appointments for patients with specialists or for additional diagnostic tests as needed.
    • Ensure that appointments align with both patient and specialist availability.
  6. Follow-Up:

    • Track and manage the status of pending referrals to ensure timely completion.
    • Follow up with patients to confirm receipt of specialist appointments and address any concerns.
  7. Collaboration:

    • Collaborate with other administrative staff, healthcare providers, and specialists to optimize the referral process.
    • Participate in regular meetings to discuss and improve referral workflows.

KNOWLEDGE, SKILLS, & ABILITIES: 

  • High school diploma or equivalent; additional education or certification in healthcare administration is a plus.
  • Previous experience in insurance eligibility verification and prior authorization within a medical setting, preferably in dermatology.
  • Familiarity with medical terminology, insurance processes, and electronic health record systems.
  • Excellent communication skills, both written and verbal.
  • Strong organizational skills and attention to detail.
  • Ability to work independently and collaboratively in a fast-paced healthcare environment.
  • Familiarity and comfort with navigating local IPA/HMO portals, including Optum, Hoag Physician Partners, Availity, etc.

 

PHYSICAL AND MENTAL DEMANDS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential job responsibilities.

While performing the duties of this job, the employee is occasionally required to stand; walk; sit for extended periods of time; use hands to finger, handle or fell objects, tools, or controls; reach with hands and arms; climb stairs; balance, stoop, kneel, bend, crouch or crawl; talk or hear; taste or smell. The employee must occasionally lift, push, pull and/or move up to 20 pounds. Required specific vision abilities include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

PAY AND HOURS:

$18 - $21/hr. Part time, 8 hour days.  

NOTE:  This job description may not include all of the duties assigned to the employee and may be updated and modified by the department supervisor, according to the operations at any given time.

 

Average salary estimate

$40680 / YEARLY (est.)
min
max
$37680K
$43680K

If an employer mentions a salary or salary range on their job, we display it as an "Employer Estimate". If a job has no salary data, Rise displays an estimate if available.

What You Should Know About Eligibility and Referral Coordinator - Newport Beach, CA, PhyNet Dermatology LLC (External)

Looking for a rewarding role in healthcare? Join us as an Eligibility and Referral Coordinator at our vibrant dermatology office in Newport Beach, CA! As an essential part of our team, you will be the bridge between patients and healthcare providers, ensuring that referrals are processed smoothly and efficiently. Your day-to-day responsibilities will involve reviewing referral requests, verifying information, and maintaining clear communication with both patients and specialists. With your organizational skills and keen attention to detail, you'll adeptly manage all documentation and keep accurate records within our electronic health system. Your role will be pivotal in coordinating insurance coverage and appointment scheduling, allowing our patients to receive timely care. You’ll not only handle the immediate tasks but also work collaboratively with our medical team to improve our referral workflows. We welcome applicants who thrive in a dynamic environment and have a background in medical administration or dermatology. Join us for a fulfilling journey where your efforts will enhance the overall patient experience, ensuring that everyone gets the care they need. If you’re passionate about making a difference in people’s lives while working in a supportive and innovative setting, consider applying for this position and be part of our growing family!

Frequently Asked Questions (FAQs) for Eligibility and Referral Coordinator - Newport Beach, CA Role at PhyNet Dermatology LLC (External)
What does an Eligibility and Referral Coordinator do at the Newport Beach dermatology office?

As an Eligibility and Referral Coordinator at our Newport Beach dermatology office, your main responsibility will be to manage referral processes, ensuring that patients are connected with the right specialists. This involves verifying referral details, communicating effectively with both patients and healthcare providers, and maintaining meticulous records within our electronic health system. Your organizational skills will significantly enhance the patient experience by ensuring timely care.

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What qualifications are required to apply for the Eligibility and Referral Coordinator position in Newport Beach, CA?

To apply for the Eligibility and Referral Coordinator role at our Newport Beach location, you will need at least a high school diploma, although additional education in healthcare administration is a plus. Previous experience in insurance verification or prior authorization in a medical setting—preferably dermatology—is also highly valuable. Familiarity with medical terminology and EHR systems is essential, as well as excellent communication skills and attention to detail.

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What is the typical work schedule for the Eligibility and Referral Coordinator at the Newport Beach dermatology office?

The Eligibility and Referral Coordinator position in our Newport Beach dermatology office typically consists of part-time hours, averaging 8-hour days. This flexible schedule allows for work-life balance while still being an essential part of our healthcare team. Specific shifts and hours will be discussed during the interview process.

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What is the pay range for the Eligibility and Referral Coordinator position in Newport Beach?

The pay range for the Eligibility and Referral Coordinator role at our Newport Beach dermatology office is between $18 and $21 per hour. This competitive wage is commensurate with your experience and contributions to our team's success in delivering top-notch healthcare to our patients.

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What skills are crucial for a successful Eligibility and Referral Coordinator in Newport Beach?

Successful Eligibility and Referral Coordinators in Newport Beach should possess strong organizational skills, excellent communication abilities, and a keen attention to detail. Familiarity with insurance processes and the ability to navigate electronic health record systems are vital for efficiently managing patient referrals and documentation.

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How can I stand out while applying for the Eligibility and Referral Coordinator position?

To stand out while applying for the Eligibility and Referral Coordinator position at our Newport Beach dermatology office, highlight any relevant experience in healthcare administration, particularly in dermatology. Showcase your ability to manage multiple tasks and emphasize any previous roles involving patient communication or insurance verification. A passion for enhancing patient experiences will certainly catch our eye.

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What opportunities for growth are available for Eligibility and Referral Coordinators at the Newport Beach office?

Eligibility and Referral Coordinators at our Newport Beach office have various opportunities for growth. By demonstrating your proficiency in managing referrals and enhancing patient communication, you may advance into roles with more responsibility, such as a supervisory position or specialized roles focusing on patient care management.

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Common Interview Questions for Eligibility and Referral Coordinator - Newport Beach, CA
Can you describe your experience with managing patient referrals?

When answering this question, it's crucial to detail your previous roles where you processed referrals. Discuss how you ensured accuracy and handled any potential discrepancies, emphasizing your attention to detail and communication with healthcare providers and patients throughout the process.

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How do you handle a situation where a referral request is incomplete?

In such scenarios, it's best to explain your approach to resolving the issue. You would typically start by contacting the referring party for the missing information and keeping the patient informed about the process. Emphasizing good communication and problem-solving skills will be key in crafting your answer.

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What software or electronic health record systems have you used in previous positions?

Be prepared to discuss specific systems you've used, like EHR platforms or referral management software. Highlight your ability to learn new technologies swiftly and how you've used these tools to enhance patient care or streamline referral processes.

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Describe a time you improved a process in a healthcare setting.

When addressing this question, focus on a particular incident where you identified a gap in the referral process and what steps you took to address it. Include details on how your actions resulted in improved efficiency or patient satisfaction, demonstrating your proactive nature.

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How do you prioritize tasks when managing multiple referrals?

In your response, illustrate your organizational abilities. Talk about how you assess which referrals require immediate attention based on urgency and the nature of the patient’s needs, and how you maintain clear documentation to ensure nothing falls through the cracks.

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What do you consider the most challenging aspect of being an Eligibility and Referral Coordinator?

Reflect on common challenges like managing incomplete documentation or coordinating with busy healthcare providers. Discuss strategies you employ to overcome these challenges, highlighting your resilience and commitment to patient care.

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How do you maintain effective communication with healthcare providers?

Explain your approach to establishing and maintaining relationships with referring physicians. Discuss the importance of clear, regular communication—whether through phone calls, emails, or meetings—to build mutual understanding and improve coordination.

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What role does insurance verification play in the referral process?

Discuss how insurance verification affects patient referrals, emphasizing your understanding of policies and coverage requirements. Talk about how verifying insurance not only streamlines the referral process but also alleviates concerns for patients regarding their costs.

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How would you handle a frustrated patient regarding their referral?

Describe your approach by emphasizing empathy and active listening. Reassure the patient that you will work to resolve their concerns swiftly and keep them informed throughout the process, showcasing your commitment to patient satisfaction.

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Can you give an example of effective teamwork in your previous roles?

Highlight a situation where you collaborated with healthcare providers or administrative staff to improve the referral process. Focus on the shared goal and how teamwork led to successful outcomes, emphasizing your ability to work well with others.

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FUNDING
SENIORITY LEVEL REQUIREMENT
TEAM SIZE
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LOCATION
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SALARY RANGE
$37,680/yr - $43,680/yr
EMPLOYMENT TYPE
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DATE POSTED
November 29, 2024

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