Referrals Specialist - Behavioral Health

Position Purpose

Under the direction of the Health Information Manager, the Behavioral Health (BH) Referral Specialist is responsible for maintaining and processing referrals and related support services for staff and clinicians in our medical clinics.

Job Type: Full time

FLSA Status: Hourly, Non-exempt

Reports to:  Health Information Manager

Essential Functions

  • Coordinate incoming, internal and external patient referrals to specialist as requested by physicians in a timely manner;
  • Create charts and document status of referrals into EMR system;
  • Send tasks to appropriate staff members for scheduling of return approved referrals;
  • Contact organizations and insurance companies to ensure prior approval requirements are met;
  • Document all client interactions in the EHR referral entry  in a timely manner;
  • Referrals notifies patient of approval and provides place of service. It is up to the patient's discretion to schedule the appointment;
  • Call insurance companies to verify BH benefits and contracting status;
  • Handles multiple phone lines;
  • Effectively communicate with all levels of individuals; (assigned Health Center Staff);
  • Call Insurance company to verify BH Benefits and contracting status;
  • Perform other job-related duties as assigned.

Required Education and Experience

  • Graduate from a high school, or possession of a certificate of proficiency issued by the California State Board of Education, or possession of a G.E.D. certificate;
  • Associate of Arts/Associate of Science Degree with experience in medical field or three years of experience working in a medical office;
  • Knowledge of managed care and private insurance guidelines for referrals;
  • Knowledge of ICD-10 and CPT Codes coupled with Medical Terminology;
  • Two years' experience with physician referral process;
  • Ability to demonstrate excellent verbal and written communication skills.

Preferred Education and Experience

  • Ability to:
    • Demonstrate organizational skills and be able to manage competing priorities;
    • Exhibit resourcefulness in problem solving;
    • Take and follow through with delegated tasks and accountability;
    • Work with persons of diverse populations;
    • Be a self-starter and self-motivated;
    • Interface effectively in a team environment with agency staff and volunteers;
    • Empathize with others and defuse conflicts; handle crisis in a calm and respectful manner;
    • To understand, use and manage your own emotions;
    • To exchange views without conflict.
  • Bilingual/Spanish.

License(s) and Certification(s)

  • N/A

Working Environment and Physical Demands 

This job operates in a clinical setting and requires constant times of sitting, standing, talking and repetitive motion. Ability to lift up to 24 pounds. Patient contact that does not involve exposure to blood, body fluids, non-intact skin or tissue specimens. Employee does not perform or help in emergency medical care or first aid.

Other Duties

Please note that this job description is not designed to cover or contain a comprehensive listing of everything that is required of the employee for the job. Duties, responsibilities and activities may change at any time with or without notice.

Work Authorization/Security Clearance

This job requires full proof of authorization to work in the United States without any future requirement of sponsorship for work visa.

Affirmative Action Plan (AAP)/Equal Employment Opportunity (EEO) Statement 

We are an Equal Opportunity Employer (EOE) and a Drug Free Workplace. In order to obtain a culturally diverse staff, we encourage applications from individuals with varied experiences, perspectives, and backgrounds. Applications from minorities, members of the transgender community and female candidates are strongly encouraged to apply.

It is the policy of DAP Health to provide equal employment opportunities for applicants and employees without regard to race, color, religion, national origin, sex, sexual orientation, gender identity, gender expression, veteran status, age, disability or any other classification protected by federal, state or local laws. DAP Health welcomes the opportunity to provide reasonable accommodations to applicants with disabilities. If you require an accommodation during the employment process, please notify People Operations. Any employment relationship with DAP Health is at-will. This means employment can be terminated at any time, with or without notice or cause, at the option of either DAP Health or the employee.