Patient & Insurance Coordinator
1 month ago
Are you ready to join a community of professionals who strive to improve the lives of others while working to light the way in the medical industry? Solis Acupuncture is a thriving acupuncture practice with clinics in Santa Cruz and Scott’s Valley. We are a growing company- our culture is positive, compassionate, and committed to growth and patient satisfaction. It's more than a job, it's a lifestyle of fostering optimal health for our patients, our employees, and ourselves.
Join our team where your passion for leadership and creativity will be valued The founders are two women who started the business from the ground up. They have worked every position in the company and as such, are humble, kind and appreciative of all their staff members.
The Patient Coordinator coordinates all aspects of care for all New Patients (NP), from their initial phone call until they arrive for their first visit. The Patient Coordinator takes all incoming NP calls and works to ensure that they become established patients. The Patient Coordinator tracks referrals/authorizations for all patients, and communicates information as needed to other employees (e.g insurance biller, providers, receptionists). The Patient Coordinator is the NP’s main contact and advocate as they enter into our care and remains a resource to them throughout treatment. The Patient Coordinator reports directly and routinely to the practice manager and insurance biller, and completes regular reports for various management team members as requested.
Principle Accountabilities and Tasks:
- Receive and organize new patient referrals from insurance companies, other physicians, and workers comp.
- Perform insurance benefits checks by calling insurance companies or using online portals, and effectively evaluate patient coverage.
- When discrepancies arise, effectively communicate with insurance companies and insurance biller to find resolutions
- Call patients and effectively communicate benefits and get patients scheduled.
- Effectively and accurately onboard new patients by entering demographics and insurance info, and upload all documents
- Referral coordination and management for all patients
- Regular follow-up and tracking of existing patients waiting on new referrals and scheduling more appointments.
- Coordinate with insurance biller to ensure claims are processed accurately and get paid.
- Work closely with the Billing department: Communicate and follow/up with Billing on claims, patients payments, credits, and insurance issues and coverage.
- Accurately keep visit count for all insurance patients, and request more visits with new patient coordinators from insurance companies.
- Develop and manage referral request system, communication, and process: Referrals and expiration dates, new authorizations requests, and streamline communication and workflow with providers, reception, and insurance patient coordinators including process for reception to track visits count and expiring referrals, authorizations, cash pay packages, and insurance limits.
- Coordinate and direct providers and receptionists in regard to referrals, patients insurance coverage, and payments.
- Yearly update of insurance: In January of every year do benefit checks to update insurance for all patients on the schedule, and track patients that have insurance renewal that is not a normal calendar year and update insurance information yearly (often starts in October).
- Have systems in place to check with patients to see if their insurance has changed throughout the year. Perform benefit checks throughout the year to keep patient insurance up to date.
- Be available to all acupuncturists and clinical staff for any issue or matters that arises for new patient coordination, insurance, cash pay and referrals.
- Administrative management of workers comp: Aid reception and clinical staff in navigating the complexities of the workers comp system and patient referrals.
- Attend regular reception meetings.
- Attend regular meetings with office manager and insurance biller over Zoom.
Part-time Employee Benefits:
Certain Paid holidays
5 days of paid sick leave
401k after 1 year of employment and 1000 hours worked
Qualifications and Requirements:
- Preferred 1 year experience in a management/supervisor role in a medical office
- Preferred 2 years experience and knowledge of California medical health insurance
- Exceptional organizational and time-management skills
- Exceptional leadership, interpersonal, and communication skills
- Must be familiar with OSHA and HIPAA standards
- Expert knowledge of EHR's, scheduling software, and phone systems
- Competency and experience in navigating California medical insurance including HMO managed care with Kaiser, PPO's including: Blueshield, Blue Cross, Optum, Cigna, Aetna, etc.; and workers comp
- Medical office experience with insurance billing
- Must have reliable high-speed internet, reliable computer that is designated for work only, and that is HIPAA compliant, and a phone to work from.
- Must have a designated home office that is comfortable, safe, and ergonomic
- Must be available to work during normal working hours of 9-5pm PST.
Skills:
- Excellent communication skills (verbal and written) and ability to explain and provide instructions to new patients
- Strong customer service skills
- Clearly communicate insurance benefits to new patients and help patient navigate the difficulties of insurance billing and problems that arise
- Must have excellent team working skills, effective interpersonal skills, and time management
- Must be detail-oriented
- Must have strong computer skills and typing ability. Competency and experience working with various computer programs
- Ability to effectively work remotely by demonstrating self-motivated, discipline, and maintain good time management.
- Able to solve problems independently, organized, collaborative, resourceful, and not afraid to ask for help.
- Able to meet work performance and/or productivity levels while working remotely
remote work
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