NEW JOB OPENING
HOME HEALTH REFERRAL COORDINATOR EPIC & AUTHORIZATION MANAGEMENT
IN Pasadena, CA, USA!

Required Education:

• High School Diploma or equivalent



Preferred Education:

• Bachelor's degree



Required Qualifications / Skills / Experience:

• Minimum 2 years of clerical, healthcare operations, referral coordination, case management support, or authorization processing experience

• Experience working with electronic medical records and referral management systems

• Knowledge of healthcare insurance, benefits, and authorization processes

• Strong organizational, analytical, and critical thinking skills

• Ability to manage multiple priorities in a demanding environment

• Proficient in Microsoft Office applications and healthcare information systems



Preferred Qualifications / Skills / Experience:

• Experience in Home Health, Managed Care, Utilization Management, or Referral Management

• Experience with Epic, authorization systems, and Electronic Medical Records (EMR) work queue management



Work Location:

• Onsite - Pasadena, CA 91103



Parking Information:

• Parking structure



Schedule:

• Shift times will vary based on operational needs between 8:00 AM and 6:30 PM - Notice will be provided in advance

• Open weekends and holidays - Contractors will be assigned rotating weekends and holidays if needed



Interview Process:

• Interview with Direct oversight manager



Dress Code:

• Casual professional attire - Friday/Weekends, casual jeans ok, no ripped or holes in jeans



Overview:

Supports Care at Home referral operations by reviewing, validating, coordinating, and processing Home Health referrals with community agency partners. This role collaborates with nurses, intake teams, and external providers to ensure referrals are processed accurately, timely, and in compliance with organizational policies and payer requirements.



Job Summary:

Care at Home Referral Management Hub Operations - Position responsible for processing referrals for outsourcing to community agencies, troubleshooting escalations, and coordinating with internal teams to obtain clarification.



Job Responsibilities:

• Review and validate referrals based on service area and zip code eligibility, coverage and payer requirements, discipline requirements, Do Not Outsource restrictions, AMCAH and Palliative Care exclusions

• Process Start of Care (SOC) and Orders Only referrals according to established workflows

• Update referral status, episode information, and referral notes within Epic system

• Coordinate referral placement with contracted community agencies

• Generate and send referral packets and supporting clinical documentation through Affiliate Link (AFL) or designated systems

• Ensure referrals are routed to appropriate workqueues for continued processing

• Effectively manage referral escalations and ensure referrals are appropriately redirected

• Review and resolve referrals requiring manual intervention including Letter of Agreement (LOA) referrals

• Resolve business and system exceptions impacting referral completion

• Research referral discrepancies and collaborate with operational teams for resolution

• Create, modify, and complete referral authorizations within Epic system

• Verify approved services, visit frequencies, and authorized dates

• Generate and distribute letters of authorization to home health agencies

• Prioritize referrals according to urgency, referral age, and organizational priorities

• Monitor assigned workqueues and maintain productivity standards

• Perform manual referral review and processing during system downtime

• Partner with CAD Nurses, Intake staff, referral coordinators, leadership, and community agencies



Industry:

Healthcare

• **Only those lawfully authorized to work in the designated country associated with the position will be considered.**

• **Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client’s business needs and requirements.**