Care Coordinator-Referrals at Primary Care & Hope Clinic

Murfreesboro, Tennessee, United States -

Full Time

Start Date

Immediate

Expiry Date

22 Jan, 26

Salary

0.0

Posted On

24 Oct, 25

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Care Coordination, Health Insurance Enrollment, Patient Service, Assessment, Continuity of Care, Referral Management, Insurance Pre-Authorization, Documentation, Communication, Problem Solving, Organizational Skills, HIPAA Compliance, Support for Underinsured, Team Collaboration, Patient Experience Improvement, Performance Improvement

Industry

Hospitals and Health Care

Description

Description Reports To: Care Coordination Manager Employee Status: Non-Exempt (Regarding Overtime) Position Summary: The Care Coordinator works in collaboration with Primary Care & Hope Clinic Medical and Behavioral providers and outside providers to assist patients and their families with the coordination of their healthcare. Essential Functions: Care Coordination: Represent PC&HC to patients/visitors in a caring, courteous, and professional manner. Provide prompt, efficient, and accurate patient service. Perform health insurance enrollment-related duties, including responding to requests for information; generating interest in enrollment through outreach, application assistance, and follow-up; documentation of activities; access, utilization, and retention duties; and related tasks. Assess the physical, functional, social, psychological, environmental, and financial needs of clients/patients; identify a cost-effective comprehensive plan to meet the families’ health care needs and implement the plan. Assess the client’s formal and informal support systems. Promote timely access to appropriate care Increase continuity of care by managing relationships with tertiary care providers, transitions-in-care, and referrals Referral Program: Make appropriate and timely referrals to specialist, DME or home health agency per request of provider. Contact the insurance carriers and initiate the referral process. Remain current on insurance pre-authorization requests. Respond promptly to calls from patients regarding the referral process. Compile all pertinent medical data and supporting documentation and fax or mail to appropriate specialist. Act as liaison between practice, patients, and referral sources complaints and problems. Plan and organize workload to maintain efficient patient operations in the health center. Prioritize patient referrals when needed. Locate and verify the participating specialist or specialty services always keeping the list current. Obtain pre-authorization from insurance carriers or other third-party payer or services to be rendered to patients at other locations. Marginal Functions Improve the patient experience and health care processes and help assure the provision of high quality health care, as well as an ongoing process of performance improvement. Completes all required paperwork Perform all other duties as required or assigned. Requirements Requirements · Must have a high school diploma or equivalent · Education or experience in healthcare healthcare-related field preferred · Must be willing to become a Certified Application Counselor for health insurance enrollment purposes. · Must communicate with patients in a friendly, positive manner. · Must be able to operate office-related equipment. · Must follow HIPAA and OSHA requirements. · Must be supportive of our mission to provide healthcare to the underinsured and uninsured.

Responsibilities

The Care Coordinator collaborates with medical and behavioral providers to assist patients and their families in coordinating healthcare. This includes managing referrals, insurance processes, and ensuring timely access to appropriate care.