The care coordinator is responsible for maintaining a highly professional environment, ensuring a collaborative relationship with patients, sleep physicians, referring physicians, as well as front staff, manager, and other professionals. The care coordinator also works closely with Durable Medical Equipment (DME) companies. The Care Coordinator will assist with scheduling. The responsibilities of this position would include insurance verification, assisting with the pre:authorization process and acting as a liaison between the providers and patient. The Care Coordinator will provide updates to the patient and doctors on timing and status of the authorizations as delays or insurance denying a pre:authorization could have an impact on the patients health and/or testing and treatment options. Once the preauthorization was complete and the appointments scheduled, the Care Coordinator would provide the patient with an itinerary when possible. The Care Coordinator will support patient care activities ensuring even patient flow and continuous communication with the patients, providers, referring physician offices and staff.
:Coordinate patient care services and assist as requested with all referrals and ensure eloquent workflow.
:Process all Durable Medical Equipment (DME) orders.
:Requests authorizations for equipment and other services as needed.
:Updates Sleep Disorder Clinic data base.
:Gathers and computes data for monthly compliance reports.
:Handles all Durable Medical Equipment (DME) paperwork and processes associated with DME.
:Assist with pre:authorization process, acting as a liaison between the physician office and patient. Provide updates to patients and MDs as needed on timing and status of authorizations.
:Facilitate referrals to appropriate care providers as requested.
:Coordination of care across the continuum.
:Link patient/family to appropriate resources as needed.
:Improve patient access to care by navigating through identified barriers.
:The position will require solid analytical skills, account management skills.
:Communicates effectively with provider team regarding changes in schedule, patient issues.
:Facilitates the identification of issues and solutions related to the delay in the verification or authorization process.
:Interfaces with hospital department management and staff to ensure proper communication is handled involving authorizations, medical necessity and scheduling.
:Effectively works within a team atmosphere, has strong customer service expertise, has ability to multi:task and proficient computer skills.
:Coordinate with physician offices pending authorizations, peer to peer requests or as necessary.
:Assists with scheduling, answering phones, and other front office duties as necessary to assure efficient patient care.
:Clinical Care: Ensure that quality patient care is delivered to all patients on a 24:hour basis, and the unit is maintained in accordance with professional and regulatory standards and the philosophy and goals of Hoag.
:Perform other duties as assigned
Education, Training, and Experience
Required: High School Graduate or equivalent
Preferred: Bachelors degree in healthcare:related field
Skills or Other Qualifications
:Self:directed individual with ability to prioritize multiple tasks and meet deadlines, excellent attention to detail, and maintain a high level of work quality.
:Strong team player with excellent communication skills.
:Proven ability to interface with customer levels (physicians, staff, insurance companies, patients and family members.
:Working knowledge of Microsoft Office Suite, including Outlook, Word, Excel, and PowerPoint, plus healthcare database systems.
:Capable of exercising good judgment under pressure
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