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Care Coordinator

2 months ago


Phoenix, Arizona, United States Upward Health Full time
About the Role

Upward Health is seeking a highly skilled and compassionate Care Navigator to join our multidisciplinary team. As a Care Navigator, you will be the single point of contact for our patients, ensuring a seamless experience and providing extensive support and assistance.

Key Responsibilities
  • Single Point of Contact
    • Coordinate with providers and Care Team members to provide ongoing support and communication to our patients and ensure a smooth continuum of care
    • Monitor patient hospitalizations and follow up as necessary with Care Team staff
    • Provide patients with educational materials and execute correspondence to primary care physicians and specialists for new patient enrollments/appointments
    • Collect, verify, & coordinate clinical and administrative information (e.g., Hospitalizations, Insurance)
  • Patient Registration
    • Perform outbound calls to patients to understand their clinical needs and connect them with appropriate resources
    • Collect, enter, and/or confirm patient demographic, health, insurance, and payment information in EHR and related systems
    • Help patients register for and access the EHR patient portal
    • Explain Upward Health's payment policy to patient
    • Facilitate completion of new patient forms
  • Insurance Verification and Authorization Fulfillment
    • Verify patient insurance information using insurance card and payers' portals
    • Contact payers for out-of-network inquires and to determine coverage policies
    • Identify patient cost-sharing amount and enter in EHR and related systems
    • Identify and complete prior authorizations for services and medications
    • Monitor insurance changes and identify/research established patients who lose eligibility
  • Scheduling & Check-in
    • Ensure that patient appointments with Upward Health providers are scheduled promptly and efficiently
    • Manage patient appointment cancelation and rescheduling as needed
    • Ensure patient missed appointments are rescheduled and communicated to the physician/clinician, patient, and members of the Care Team
    • Maintain system of notifications sent to patients about scheduled appointments
    • Attach any pre-visit paperwork to the patient's EHR chart
    • Ensure completion of as-needed patient clinical and administrative forms ahead of visits
    • Contact patient in advance of or at beginning of appointment to complete check-in and:
      • Confirm demographic information
      • Confirm patient insurance eligibility
      • Review patient account balance and any co-payments due
      • Collect payment information from patients, including processing credit card payments for patient cost-sharing amounts
      • Notify patients of necessary future appointment details
    • Provide minor technical assistance to ensure that patients can access virtual visits
  • Follow Up Support from Provider Visits
    • Assistant the providers delivering care as it relates to pre and post visit documentation, following up on orders, faxes, and labs, and ensuring smooth experience for patient and provider
    • Perform outbound calls to providers to make appointment for patients or follow up on care
    • Follow up with patients to ensure their needs are met and schedule future wellness discussions
    • Expedite follow up to further coordinate next steps as to the patient response, scheduling needs and insurance coordination
  • Various Administrative Support and Other Duties
    • Lead the answering of the phone and responding to the fax machine for patient inquires
    • Answer inbound calls from patients, providers, and Upward Health resources as necessary
    • Collaborate with Finance colleagues on patient billing issues
    • Handle medical record requests
    • Manage the incoming queue of patient referrals
    • Prepare reports and documents as needed or requested, ensures Care Team is following proper documentation protocols at the direction of the Manager
    • Attend regular team meetings and participate in clinical rounds
    • Maintain patient, provider, & payer contact & referral Information
    • Other duties as assigned
    Requirements
    • 3+ years at an outpatient healthcare practice serving as a patient representative or similar experience
    • High school graduate or GED required
    • Prior experience in health insurance and medical terminology is preferred
    • Knowledge of community resources in applicable geographic area
    • Able to maintain clear professional boundaries with members and coworkers
    • Cultural competency – able to work with diverse groups of community members
    • Highly technologically savvy
    • Report development from clinical and non-clinical systems
    • Ability to assist with development and distribution of educational materials

Upward Health is proud to be an equal opportunity/affirmative action employer. We are committed to attracting, retaining, and maximizing the performance of a diverse and inclusive workforce.

This job description is a general outline of duties performed and is not to be misconstrued as encompassing all duties performed within the position.