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Patient Care Coordinator

2 months ago

Marlborough, Massachusetts, United States Optum Full time
Optum Job Description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives.

The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best.

Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities.

We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes.

Job Responsibilities
  • Verify and authorize patient insurance coverage and eligibility using computer-based patient registration/scheduling systems.
  • Update demographic, insurance, and other patient information.
  • Collect and post patient co-payments and other outstanding balances.
  • Generate and track patient encounter forms, reviewing them for completeness and resolving any discrepancies.
  • Maintain records and make daily cash deposits as assigned.
  • Receive and address patient care-related telephone calls, providing routine information on procedures and standard policies.
  • Identify problem-related priorities and respond to emergency needs by contacting or interpreting physicians/providers within guidelines.
  • Resolve patients' questions regarding clinic schedules and billing concerns, handling requests for prescription refills, rescheduling appointments, etc.
  • Document appropriate information in computer systems.
  • Prepare patient charts, ensuring completeness by locating test results, reminding patients of appointments, and including appropriate forms.
  • Update and maintain the Telephone Message System (TMS) in computer systems, following through on requests and distributing messages to appropriate providers or others for action.
  • Enter new referrals or ensure existing referral numbers are linked in the system to meet managed care requirements.
  • Provide patient education regarding managed care plans and referral processes, answering patients' referral 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 referrals or obtain them 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, 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.
  • May escort patients to examination rooms and chaperone patients as required.
  • May process standard and non-standard business office administrative paperwork, such as purchase requisitions, employee timesheets, expense vouchers, etc., following up with personnel outside the medical office to expedite timely action and alleviate or report delays as appropriate.
  • Provide guidance to departmental personnel in medical offices on administrative policies and procedures.
  • Comply with health and safety requirements and with regulatory agencies such as DPH, etc.
  • Comply with established departmental policies, procedures, and objectives.
  • Enhance professional growth and development through educational programs, seminars, etc.
  • 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, etc.
  • 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