The Care Coordinator (also referred to as a Referral Coordinator) is responsible to the Center Administrator and assists with medical management data entry and referral functions.
ESSENTIAL FUNCTIONS:
Consistently exhibits behavior and communication skills that demonstrate commitment to superior customer service, including quality and care and concern with each and every internal and external customer.
Represents the Company in a professional manner, following all Company policies and procedures.
Uses, protects, and discloses patients protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
Responsible for total coordination and processing of all patient referrals for specialty services.
Follows protocols for proper authorization and processing of all referrals.
Communicates with the patient on a timely basis for all scheduling requirements.
Coordinates pre-admission testing requirements with clinic personnel and patient.
Completes all administrative functions associated with referral activities in a timely manner.
Enters all referral, hospital, outpatient, DME and other patient specialty health service authorizations into the computer system according to Company policy and procedure.
Receives consultant reports, maintains documentation, and routes to the appropriate physician promptly.
Responsible for monitoring all referral reports not received and timely follow-up in accordance with Company policy and procedure.
Performs other duties as assigned.
Must have consistent, punctual and reliable attendance.
Ability to travel may be required.
EDUCATION:
High school graduate, GED or equivalent.
EXPERIENCE:
Previous medical office experience with referral processing for HMO plans is preferred.
KNOWLEDGE, SKILLS, ABILITIES:
Ability to interact and verbally communicate effectively with patients and all levels of personnel in a professional, courteous and effective manner with excellent customer service skills.
Possess excellent communication and organizational skills with the ability to multi task, set priorities, and meet deadlines.
Results and goal-oriented with a philosophy for quality improvement.
Must be computer literate and have exceptional telephone skills.
Possess high job accuracy, efficiency, and dependability.
Knowledge of HIPAA regulations.
Ability to read, speak, write, and understand the English language fluently.
Ability to multi- task in a high paced environment with good organizational skills.
Ability to follow written and oral instructions and to work with general guidance.
Previous experience with EMR systems is a plus.
Knowledge of medical coding a plus.
Numbers & Facts
Location
Optum Florida, TX
Skills
Access Authorizationunmatched
Administrative Skillsunmatched
Communication Skillsunmatched
Computer Servicesunmatched
Computer Skillsunmatched
Computer Systemsunmatched
Consultingunmatched
Corporate Policiesunmatched
Customer Service Evaluationunmatched
Customer Support/Serviceunmatched
Data Entryunmatched
Documentationunmatched
Durable Medical Equipmentunmatched
Electronic Medical Recordsunmatched
English Languageunmatched
Establish Prioritiesunmatched
HIPAA (Health Insurance Portability and Accountability Act)unmatched
Health Maintenance Organization (HMO)unmatched
Healthcareunmatched
High School Diplomaunmatched
Hospitalunmatched
Information/Data Security (InfoSec)unmatched
Medical Assistanceunmatched
Medical Codingunmatched
Medical Officeunmatched
Multitaskingunmatched
Organizational Skillsunmatched
Outpatient Careunmatched
Philosophyunmatched
Presentation/Verbal Skillsunmatched
Quality Managementunmatched
Regulationsunmatched
Staff Requirementsunmatched
Telephone Skillsunmatched
Test Requirementsunmatched
Time Managementunmatched
Willing to Travelunmatched
Writing Skillsunmatched
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