Referral Authorization Coordinator (RHC)

Position Summary The Referral and Authorization Coordinator is responsible for compiling, processing, and maintaining electronic and traditional medical records for clinic patients in accordance with medical, administrative, ethical, legal, and regulatory standards.

This position works directly with Paskenta Nomlaki Tribal Members, providers, and healthcare facilities to efficiently coordinate referrals and obtain authorizations.

The role requires careful handling of sensitive medical information and strict adherence to HIPAA and clinic procedures.

Essential Duties/Responsibilities Answer questions about Rolling Hills Clinic and Tribal Member Support Department, providing accurate information.

Offer assistance with the patient portal and other healthcare requests.

Verify patient demographics for every patient and keep all records, forms, and data files updated in the Electronic Medical Record and other systems.

Protect the confidentiality and security of medical records (HIPAA).

Work independently to complete daily duties requiring minimal supervision.

Provide and accept feedback professionally; communicate clearly in both individual and group settings.

Handle inbound inquiries regarding referrals/prior authorizations, screening requests per benefit plan, insurance, clinical criteria, and patient needs.

Process and follow-up all incoming and outgoing referrals and authorizations promptly per RHC guidelines; consistently communicate updates and document all interactions.

Maintain organized records of all requests and update the Electronic Medical Record and tracking spreadsheets.

Maintain a high level of customer service, professionalism, attention to detail, emotional intelligence, and listening skills.

Demonstrate proficiency with computer systems, technology, and office equipment.

Maintain compliance with ergonomic safety standards, including regular posture checks and stretches.

Ensure optimal safety and health practices for self and others at all times; take corrective action on any safety concerns.

Must have the ability to relate and communicate effectively with community interest groups, agencies, and medical facilities that serve the American Indian Community.

Participate in mandatory in-service programs and assigned committees.

Maintain punctuality, reliability, and attendance standards.

Performs other duties as assigned.

Qualifications Required Education & Experience Must be at least 18 years of age.

High school diploma or equivalent.

At least one (1) year working in a medical facility.

Preferred Education & Experience Associate's or Bachelor's degree in a related field such as health information management, medical office administration, or healthcare.

Licenses/Certificates Valid BLS Certification Valid California Driver's License Pre-Employment Requirements MERGEFIELD PreEmployment_Requirements Pre-employment drug testing.

Department of Justice fingerprint clearance through Federal, State, and Child Abuse Index.

Working Environment ...