Managed Care Coordinator - Infusion

Primary Job Responsibilities/Tasks may include, but not limited to:

The duties and responsibilities of this position include assisting patients and providers with coordinating of referrals, obtaining authorizations and scheduling. This position is also responsible for understanding benefits coverage and ensures the patient’s care is coordinated.

This position will support our Infusion team at SouthPark. 

Responsibilities:

• Completes referrals for patients and coordinates with referring and receiving practices and/or departments.
• Obtains all authorizations needed
• May coordinate and prepare financial estimates for patients
• Directs patients to provider in their insurance plan.
• Educates and enrolls patients in available assistance programs.
• Reviews benefits and educates patient on insurance coverage.
• Coordinates and schedules infusion procedures, diagnostic testing, or other services within various departments with internal and ancillary providers.
• Reviews schedules and confirms schedules are accurate and time is properly allocated.
• Follows up on all referrals to ensure no care gaps.
• Handle sensitive information in a confidential manner.
• Other duties as assigned.

Requirements:

Education, Experience and Certifications:

• High School Diploma or GED required.
• Thorough understanding of insurance coverage and Medical Necessity policies preferred.
• Customer service experience required.
• Knowledge of medical records software preferred.
• Completion of Hepatitis B Vaccine and Flu Vaccine Form will be required. Candidate may decline vaccination through declination form or may provide record of vaccination from previous employer.
• Completion of TB test will be required.

Physical Requirements:

• Work consistently requires walking, standing, sitting, lifting, reaching, stooping, bending, pushing, and pulling.
• Must be able to lift and support weight of 35 pounds
• Ability to concentrate on details.
• Use of computer for long periods of time.