Under the direction of the Manager, this position's primary function is to process behavioral health referral requests. The Patient Care Coordinator will verify health insurance eligibility, benefits, and processes a patient's medical referrals according to patient's insurance guidelines including obtaining prior authorization if required. The Patient Care Coordinator will contact scheduled patients at Renown Behavioral Health and inform patients of their financial responsibility and make financial arrangements if required. The Patient Care Coordinator must have a thorough understanding and use of medical and behavioral health terminology, psychological testing procedures and a understanding of levels of care for behavioral health services. The Behavioral Health Patient Care Coordinator does not make medical necessity determinations.
Nature and Scope:
1. Prioritizes daily workload so work may be done in a timely and accurate manner.
2. Must be able to read and understand the written and/or verbal orders.
3. Provides accurate data entry of patient demographic and referral, authorization and benefit information into appropriate software database.
4. Responsible for ensuring all necessary medical records and patient information is present to process referrals, authorizations and benefits.
5. Responsible for reviewing scheduled appointments in Epic and validating necessary referral, authorization and/or benefits have been obtained.
6. This position demonstrates high standards of courtesy, performance, diplomacy and respect for confidentiality that will promote a positive relationship with our customers.
7. Requires excellent communication skills to communicate effectively with customers with diverse socio-economic and ethnic backgrounds
8. Must establish and maintain effective and positive working relationships with all internal and external customers contacted in the course of duties.
9. This position will provide quality and coordination of patient scheduling, knowledge of procedures and services preparations, accurate patient instructions, and provide general customer service to the public, physicians, and all areas within Renown Health.
10. This position may also be required to fill in for any patient access representative responsibilities .
This position does not provide patient care.
The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.
Minimum Qualifications: Requirements - Required and/or Preferred
Must have working-level knowledge of the English language, including reading, writing and speaking English. Graduation from accredited Medical assistant school preferred.
Two (2) years experience in the behavioral health care field as , insurance or authorization processor, admission representative, customer service representative or comparable experience. One year utilizing medical terminology, ICD-9/10 and CPT coding and processing referrals preferred
Computer / Typing:
Computer typing and above average computer skills required. Microsoft Office software experience, including Word, Excel, PowerPoint, preferred.
Must possess, or be able to obtain within 90 days, the computers skills necessary to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.