Patient Care Coordinator-4

PRIMARY PURPOSE

To provide world class customer service and service delivery to our clients and patients through processing referrals in the delivery of medical goods and services.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

• Reaches out to patients in relation to new or already processing referrals confirming patient demographic information, providing updates on the referral, and/or confirming delivery of said goods or service.
• Communicates with vendor partners, claims adjusters and nurse case managers providing updates on new referrals as well as referrals already in process.
• Procures vendor partners for each referral as it relates to the goods or services requested.
• Responsible for making or taking phone calls on existing referrals, new referrals, or other team members referrals.
• Provides quotes back to clients for approval or follow up on quotes already sent to obtain written approval for requested referrals ensuring that each referral is deemed medically necessary and approved by the claim’s adjuster.
• Confirms all required and relevant billing information exists in each referral as it relates to the workflow and billing processes in place and moves those referrals to be billed each day.
• Processes referrals per state regulations and workers compensation guidelines.

ADDITIONAL FUNCTIONS AND RESPONSIBILITIES

• Supports the organization's quality program(s).
• Travels as required.

QUALIFICATIONS

• Education & Licensing: High school diploma or GED required. Two (2) years of industry experience in healthcare network and patient care scheduling or equivalent combination of education and experience required.
• Skills & Knowledge: Strong customer service skills, strong critical thinking skills, self-starter, excellent oral and written communication skills, PC literate, including Microsoft Office products, analytical and interpretive skills, strong organizational skills, excellent interpersonal skills, ability to create and complete comprehensive, accurate and constructive written reports, ability to work in a team environment, ability to meet or exceed Performance Competencies.