Patient Care Coordinator
- Confirm that insurance policies are active and registered correctly for the scheduled DOS.
- Update patient insurance information, including copayments and financial obligations due at time of service.
- Communicate with patients regarding high deductibles and cash rate amounts due.
- Notify patients of any issues with insurance verification or policy termination and provide options such as updating insurance or discussing cash rates.
- Add pop-up alerts for the Front Office when additional insurance information is needed or when patients are unreachable.
- Request and obtain follow-up visit authorizations via insurance carriers, online portals, or primary care providers.
- Secure authorizations for new patient visits via insurance carriers, online portals, or primary care providers.
- Create and manage referral modules based on authorizations and link them to the upcoming appointments.
- Follow established workflow
- Obtain pre-certifications/authorizations for recommended treatments via insurance carriers, primary care providers, or online portals.
- Use Healow Messenger to notify patients when treatment requests are submitted and when approvals are received.
- Follow up on submitted requests within 7–14 days.
- Route approved authorizations to he patient’s chart for processing.
- Coordinate care by faxing approvals and treatment orders to appropriate facilities and informing patients of the next steps.
- Notify medical assistants, providers, and patients of any treatment denials and schedule necessary follow-up appointments.
- Follow established workflow for Workers' Compensation treatment request and delays.
- Resolve treatment orders within 14 days; no orders should remain open past 30 days.
- Will be responsible for scheduling or rescheduling appointments based on reatment coordination, insurance eligibility, or authorization issues.
- Follow established workflows when booking appointments.
- The employee shall be responsible directly to the Patient Care Coordinator Manager. The employee shall report to the Patient Care Coordinator Manager and his/her assignees any progress, reports, requests, concerns, problems, and/or expectations in relation to the responsibilities of the position. Such communication may be verbal or written as deemed necessary by the employee or as directed by the Patient Care Coordinator Manager or his/her assignee.
- The employee shall interact with other office and clinical staff in the Practice. Such interactions should be collegial, professional, and contributing to the safety and pleasantness of the work environment at Arrowhead Orthopaedics.
- The employee shall interact with patients, medical groups, adjustors, nurse case managers, hospitals, and Primary Care Physicians and their offices. Such communication should always reflect the total commitment of the office to quality care and customer satisfaction. All communication should be professional and any unresolved conflicts are to be reported to the Patient Care Coordinator Manager
- Education: High school diploma or equivalence.
- The ability to type 40 words per minute.
- Skill in operating a computer and scanner, as well as software programs including Microsoft Outlook and preferably Practice Partner.
- Telephone etiquette, superior customer service, and professional communication skills are required.
- Must be flexible and able to multitask in a stressful setting.
- Bilingual English/Spanish
- Requires sitting and walking, with daily occasional stooping, reaching, and bending.
- Occasional lifting up to thirty pounds.
- Hearing must be in the normal range for telephone and personal communication.
- Requires manual dexterity sufficient to operate keyboards and other office equipment.`
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