Job Description:
We’re unique. You should be, too.
We’re changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial-minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy?
We’re different than most primary care providers. We’re rapidly expanding and we need great people to join our team.
The Care Coordinator is a highly visible customer service and patient-focused role. The incumbent in this role works directly with our patient population and their families, insurance representatives and outside vendors, physicians, clinicians, and other medical personnel to ensure the referral process runs smoothly. He/She operates in a dynamic and professional environment to ensure the highest level of quality healthcare is delivered to our members.
ESSENTIAL JOB DUTIES/RESPONSIBILITIES:
Definition Of Completion:
- Prioritizes HPP patients in Primary Care Physicians panel, stats expedites, and orders over 5 days.
- Orders have been approved (when needed).
- Schedules patients (Preferred Providers List of Specialists) and notifies them of appointment information, including, date, time, location, etc.
- Uses Web IVR to generate authorizations (Availity, Careplus, Healthhelp NIA, and any other approved web IVR for authorization processing).
- Completes orders with proper documentation on where the patient is scheduled and how the patient was notified.
- Referrals have been sent to the specialist office & confirmed receipt.
- Prepares and actively participates during physician/clinician daily huddles utilizing the RITS Huddle Portal and huddle guide. Effectively communicates the physicians/clinicians' needs or outstanding items regarding patients.
- Enters all Inpatient and Outpatient elective procedures in the HITS tool.
- Ensures patient's external missed appointments are rescheduled and communicated to the physician/clinician.
- Participates in Super Huddle and provides updates on high-priority patient referrals.
- Addresses referral-based phone calls for the Primary Care Physicians panel.
- Completes and addresses phone messages within 24 hours of call.
- Checks out patients based on their assigned physician/clinician. (Note: If the assigned Care Coordinator is unavailable at the time of checkout, a colleague shall assist the patient. This process does not apply to Care Specialist)
- Retrieves consultation notes from the consult tracking tool.
- Follows up on all Home Health and DME orders to ensure a patient receives services ordered.
- Provide extraordinary customer service to all internal and external customers (including patients and other
- ChenMed Medical team members) at all times. Utilization of patient messaging tools.
Knowledge, Skills And Abilities:
- Knowledge of medical terminology, CPT, HCPCS, and ICD coding desired
- Detail-oriented with the ability to multi-task. Must be open to cross-functionally training in referrals and back office duties
- Able to exercise proper phone etiquette with the ability to navigate proficiently through computer software systems
- Team-oriented with the ability to work extremely well with patients, colleagues, physicians, and other personnel in a professional and courteous manner
- Exceptional organizational skills with the ability to effectively prioritize and timely complete tasks
- Proficient in Microsoft Office Suite products including Word, Excel, PowerPoint and Outlook, database, and presentation software
- Ability and willingness to travel locally within the market up to 10% of the time
Knowledge, Skills And Abilities:
- Knowledge of medical terminology, CPT, HCPCS, and ICD coding desired
- An understanding of the company's patient population, including the complexities of Medicare programs
- Exceptional organizational skills with the ability to effectively prioritize and complete tasks in a timely manner.
- An understanding of the company's patient population, including the complexities of Medicare programs
- Detail-oriented with the ability to multi-task.
- Able to exercise proper phone etiquette.
- Ability to navigate proficiently through computer software systems & use technology.
- Ability to work well with patients, colleagues, physicians, and other personnel in a professional manner.
- Proficient in Microsoft Office Suite products including Word, Excel, PowerPoint and Outlook, database, and presentation software.
Education And Experience Criteria:
- High School diploma or equivalent required
- A minimum of 1 year of referral experience in a healthcare setting is required.
- Experience with web-based insurance sites and obtaining referrals/authorizations for multiple payors preferred.
- Experience with Web IVRs and obtaining referrals/authorizations for multiple payers is strongly preferred
- Healthcare experience within the Medicare Advantage population is preferred.
- Medical Assistant certification preferred
We’re ChenMed and we’re transforming healthcare for seniors and changing America’s healthcare for the better. Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We’re growing rapidly as we seek to rescue more and more seniors from inadequate health care.
ChenMed is changing lives for the people we serve and the people we hire. With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow. Join our team who make a difference in people’s lives every single day.
