Patient Care Coordinator

3 weeks ago

North Oxford, United States Optum Full time
Job Summary

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. We are seeking a highly skilled Patient Care Coordinator to join our team. As a Patient Care Coordinator, you will play a critical role in ensuring the smooth operation of our healthcare services.

Key Responsibilities
  • Verify and authorize patient insurance coverage and eligibility using computer-based patient registration/scheduling systems.
  • Update demographic, insurance, and other patient information to ensure accuracy and completeness.
  • Collect and post patient co-payments and other outstanding balances in a timely manner.
  • Generate and track patient encounter forms, reviewing them for completeness and resolving any discrepancies.
  • Maintain accurate records and make daily cash deposits as assigned.
  • Respond to patient care-related telephone calls, providing routine information on procedures and standard policies, and referring matters to appropriate personnel.
  • Identify and prioritize problem-related tasks, responding to emergency needs by contacting or interpreting physician/providers within guidelines.
  • Resolve patient questions regarding clinic schedules and billing concerns, handling requests for prescription refills, rescheduling appointments, and documenting information in the computer system.
  • Prepare patient charts, ensuring completeness by locating test results, reminding patients of appointments, and distributing necessary forms.
  • Update and maintain the Telephone Message System (TMS) in the computer system, following through on requests and distributing messages to appropriate providers or others for action.
  • Enter new referrals or ensure that existing referral numbers are linked in the system to meet managed care requirements.
  • Provide patient education regarding managed care plans and referral processes, answering patient questions and concerns, and offering available options.
  • Work collaboratively with primary care practices, patients, and specialty practices to process outgoing referrals prior to scheduled visits, following up with practices that do not issue a referral or obtain a referral in a timely manner.
  • Interface with staff, providers, and patients regarding denied referrals, documenting information and assisting with alternate plans of care, if needed.
  • Complete and maintain patient schedules, scheduling and coordinating patient visits and medical procedures for both inpatients and outpatients, and communicating with patients regarding all information related to scheduled appointments.
  • Notify providers, patients, and others of changes, such as new scheduling, rescheduling, no-shows, emergency appointments, and add-ons.
  • Maintain recall lists and communicate with patients as appropriate, informing nursing staff or others of laboratory and diagnostic study results, collecting and mailing test results.
  • Escort patients to examination rooms and chaperone patients as required.
  • Process standard and non-standard business office administrative paperwork, such as purchase requisitions, employee timesheets, expense vouchers, and follow up with personnel outside the medical office to expedite timely action and alleviate or report delays as appropriate.
  • Provide guidance to departmental personnel in the medical office on administrative policies and procedures.
  • Comply with health and safety requirements and with regulatory agencies, such as DPH.
  • Comply with established departmental policies, procedures, and objectives.
  • Enhance professional growth and development through educational programs, seminars, and other opportunities.
  • Attend a variety of meetings, conferences, and seminars as required or directed.
Requirements
  • High School Diploma/GED (or higher)
  • 1+ years of customer service experience
  • 1+ years of experience working in a healthcare setting
  • Intermediate level of proficiency with Microsoft Office, including Word, Outlook, Excel, and other applications
  • Ability to work in an office environment
  • Ability to work 38.75 hours a week, Monday through Friday, from 7am-5pm EST
Preferred Qualifications
  • Specialized medical secretarial/medical office training
  • Previous pediatrics experience
Soft Skills
  • Ability to multitask and resolve patient concerns in a timely manner
  • Ability to think critically and exercise sound judgment
  • Excellent communication, interpersonal, and organizational skills

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