Care Coordinator-Specialty - Lexington CHC

Responsibilities

• Receive internal referrals from primary care providers for the specialty services in CSV
• Process prior authorizations required for approval of consultations from insurers, when applicable.
• Review charts to assess appropriateness, urgency and medical necessity of specialty consultations.
• Schedule consultation appointments according to appropriateness, urgency and medical necessity.
• Work through standing orders previously designed by the specialty physicians to gather laboratory data or imaging studies required before visits.
• Develop and implement a mechanism for processing and tracking outgoing referrals ordered by specialty physicians and ensuring clients successfully follow-up on referrals.
• This includes recovering reports.
• Conduct pre-visit planning for specialty consultation and follow up encounters and obtain medical records when appropriate.
• Maintains influx of new patients into provider panels and analyzes provider capacity to absorb new patients.
• Responsible for patient transfers within and outside CSV for the assigned PCP’s.
• Patient-initiated PCP-change requests; facilitate discussion between and obtain approval from current assigned PCP and future PCP; makes the change in the practice management system.
• Provider-initiated PCP change requests. Facilitates discussion between current PCP and potential future PCs; obtains agreement of acceptance by the new PCP.
• Patient transferring care to non-CSV provider: Facilitate communication with outside provider to ensure continuity.
• Proactively engage priority patients to promote availability of expanded access to clinics and reduce unnecessary Emergency Room utilization.

Requirements

• Education: Medical Assistant certified or program completion.
• Computer proficiency: Excel, Word, Outlook, Nextgen, PDF, etc.
• Spanish speaking preferred

Qualifications

• Maintain excellent internal and external customer service.
• Maintain the highest degree of confidentiality possible when performing the functions of this department.
• Possess the tact necessary to deal effectively with patients, providers, and employees, while maintaining confidentiality.
• Must be able to work independently, handling high volume and multiple tasks.
• Must be reliable with attendance.
• Must be highly organized and detail oriented.
• Possess knowledge of modern office equipment, systems and procedures.
• Able to multi-task and work efficiently in a potentially stressful environment.
• Ability to apply common sense understanding when carrying out detailed written or oral instructions.
• Must have excellent verbal and written communication skills.
• Ability to effectively present information and respond to questions from internal and external customers.
• Must have a pleasant, professional attitude toward patients, providers, co-workers and superiors.
• Teamwork skills a must.