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LOP Case Manager

3 months ago

Addison, United States Direct Orthopedic Care Full time
Job DescriptionJob Description

Description: Utilizes effective communication to efficiently coordinate guest care via the LOP process. Works collaboratively with upper management, supervisor and peers. Continually strives to create an exceptional experience for our guests, referral sources and partners. Embodies strong front office knowledge and is service oriented. Reports to the Director or Revenue Cycle.

Core Responsibilities:

  • Fields phone calls from current and potential guests, vendors, attorneys, referring providers, etc.
  • Provide information to callers on our clinics, providers, services, billing methods, etc.
  • Greet guests in courteous, attentive and professional manner
  • Guest registration, appointment scheduling and updating existing guest demographics by collecting all necessary information
    1. Reference Pyramid PAS AR report to ensure that guests are correctly tracked for billing and AR purposes – 3 primary payers (Syndeocare, Apogee, Third Party Liability (MEG)
  • Provide quality and timely medical case management for personal injury guests
    1. Notes returned within 24 hours of every visit. Correct verbiage present in documentation to establish causality – this will require coordination between attorney and DOC provider.
  • Manage the progression of guest’s care, obtain authorizations and collaborate with physicians, attorneys, referring providers and other parties as needed.
    1. Track benefits availability and policy limits. Coordinate transfer of responsibility from liability carrier to guest or commercial health insurance when required.
  • Strives to improve the guest’s experience, provides explanation of treatment and ensures all questions are answered
  • Manage reduction requests in conjunction with Revenue Cycle Director – Currently for MEG and OKC.
  • Able to build and maintain strong professional relationships
  • Schedule appointments in a professional and timely manner
  • Must have professional oral and written communication skills
  • Maintain guest confidentiality and handle PHI in a HIPAA compliant manner
  • Other duties as assigned

Requirements:

  • Ability to work independently and/or collaborate as a team
  • Ability to effectively manage multiple projects simultaneously
  • Exhibits behaviors consistent with strong service excellence
  • Must be willing to travel to all DOC clinics in the market
  • Ability to demonstrate professional communication
  • Must be able to learn our guest management software
  • Must be detail oriented and organized
  • Must have a high school diploma
  • Must be able to problem solve independently