Summary:

Patient Care Coordinator will remain up to date on insurance requirements. Verify patient insurance to determine benefits & eligibility for the purpose of obtaining prescriptions, Certificates of Medical Necessity (CMN), Treatment Authorization Requests (TAR’s), and Service Authorization Requests (SAR’s) for services provided to patients. Ensures all required documentation is complete before delivery of all claims. Care coordinator offers financial counseling for patients prior to patient commitment to services to be rendered. This position also shares in the responsibility of tracking patient prescription through to delivery by use of the OPIE Work in Progress (WIP).

Essential Duties and Responsibilities include the following. (Other duties may be assigned)

· Prepares correspondence as necessary to obtain prescriptions, CMNs, detailed written orders and authorizations/TARs/SARs for all patients who require it.

· Obtain physicians notes, review and ensure that all requirements/coverage criteria are met

· When necessary submit an amendment/correction/late entry request to ensure documentation is accurate and insurance requirements are met for device being provided

· Responsible for documentation request follow ups on a weekly basis by phone/fax/email

· Ensures orders/prescriptions are up-to-date in OPIE WIP. Tracks orders/auths for timely completion.

· Runs weekly WIP organized by expired authorizations

· Update patient/order/document status and resolve by submitting extensions and/or requesting up to date documentation. This includes making the decision when to cancel and remove an order from tracking.

· Contacts insurance company to verify patient coverage and benefits.

· Reviews billing requirements for each service. Verifies participating or non-participating status.

· Computes fees to determine amount of patient responsibility based on insurance eligibility and coverage.

· Discusses finances with patient and documents payment arrangements as required and according to office policy.

· Communicates with practitioners to resolve questions and issues with orders and ensure timely completion.

· Ensures accuracy and completeness of all required documentation before delivery of item(s).

· Oversees and assists in training Patient Care Coordinator and Front Office Coordinator.

· Saves all correspondence that comes to VIPO via fax or email.

· Enters incoming correspondence to OPIE and performs next steps (making initial contact for initial evaluation/ submits correction on authorizations/ordering patient items)

· Remains up to date on insurance requirements.

· Run bi-weekly WIP meetings in office with Practitioners to ensure continuation of care by:

o Notes are complete

o L Codes in and verified

o Items orders and/or Work Orders created

· Attends bi-weekly All Staff Meetings in Newhall.

Secondary Responsibilities – as team members, front office staff are expected to assist with/back up other positions when department is short staffed or when otherwise needed. Duties include, but are not limited to:

· Back up other Care Coordinator(s) in absence.

· Tertiary back up for phones, check-in, check-out.

· Assist with Spanish-speaking patient phone calls and in room as a back up to primary translator.

· Projects as assigned by management

Requirements:

· High school diploma required.

· Ability to perform basic mathematical computations.

· At least two years CM/Billing experience at VIPO or within other medical office environment.

· Familiarity with government and private insurance types and requirements.

· Bilingual English-Spanish.

· High fluency in English language. Ability to understand and follow verbal and written instructions.

· Strong communication skills for directing, training, and providing feedback to others, and receiving the same.

· Ability to manage multiple tasks without errors and within deadlines/time constraints.

· Computer literate with basic skills in Outlook, MS Word and internet usage.

· Neat and legible handwriting

· Excellence in customer service. Ability to discuss and clearly explain insurance issues with patients.

· Ability to write simple correspondence, memos, and emails with correct English usage.

· Ability to use basic office equipment- computer, scanner, facsimile machine, telephone, credit card machine, photocopier, and ten-key.

· Ability to explain/demonstrate processes and to effectively train others.

Job Type: Full-time

Pay: $19.00 - $23.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee discount
• Health insurance
• Life insurance
• Paid time off
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Work setting:

• In-person

Education:

• High school or equivalent (Preferred)

Experience:

• Customer service: 1 year (Preferred)
• Medical terminology: 2 years (Preferred)
• Computer skills: 2 years (Preferred)

Language:

• Spanish (Required)

Work Location: In person