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Patient Care Coordinator

1 month ago

Framingham, United States UnitedHealth Group Full time

Primary Responsibilities: *Verifies, re-verifies, and authorizes patient insurance coverage and eligibility utilizing computer-based patient registration/scheduling system. *Verifies and updates demographic, insurance, and other patient information. Confirms, collects, and posts patient co-payments and other outstanding balances. Generates and tracks patient encounter forms. Reviews patient encounter forms for completeness and resolves any discrepancies. Batches encounter forms and submit to appropriate billing area. *Maintains records and makes daily cash deposit as assigned. *Receives and addresses patient-care related telephone calls. *Provides routine information on procedures and standard policies, refers matters to appropriate person within department/site. *Identifies problem related priorities, and responds to emergency needs by contacting/interrupting physician/provider within guidelines. *Resolves patients\' questions regarding clinic schedules and billing concerns; handles requests for prescription refills, reschedules appointments, etc. *Documents appropriate information in computer system. Prepares patient charts. Ensures completeness by locating test results, reminding patients of appointments, including appropriate forms, etc., for patient appointments. *Updates and maintains Telephone Message System (TMS) in computer system. Follows through on requests. Distributes messages to appropriate provider or others for appropriate action. *Enters new referrals or ensures that existing referral numbers are linked in the system to ensure managed care requirements. *Provides patient education regarding managed care plans and referral process. Answers patients\' referral questions, concerns, etc. *Provides patient with available options. *Works collaboratively with primary care practices, patients and specialty practices to process outgoing referrals prior to scheduled visits. *Follows up with practices that do not issue a referral or obtain referral on a timely basis. *Interfaces with staff, providers, and patients regarding denied referrals. Documents information and assists with alternate plan of care, if needed. *Completes and maintains patient schedules. Schedules and coordinates patient visits, medical procedures for both inpatients and outpatients. *Communicates with patients regarding all information related to scheduled appointments. *Notifies providers, patients and others of changes such as new scheduling, re-scheduling, no-show, emergency appointments and add-on. *Maintains recall lists and communicates with patients as appropriate. *May inform nursing staff or others of laboratory and diagnostic study results; collects and mails test results. *May escort patient to examination rooms and chaperones patients as required. May process standard and non-standard business office administrative paperwork, such as purchase requisitions, employee time sheets, expense vouchers, etc. *Follows-up with personnel outside the medical office to expedite timely action and alleviate, or report delays as appropriate. *Provides guidance to departmental personnel in medical office on administrative policies and procedures. *Complies with health and safety requirements and with regulatory agencies such as DPH, etc. *Complies with established departmental policies, procedures, and objectives. *Enhances professional growth and development through educational programs, seminars, etc. *Attends a variety of meetings, conferences, and seminars as required or directed. *Regular, reliable and predictable attendance is required. *Performs other similar and related duties as required or directed. Required Qualifications: High School Diploma/GED (or higher)

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