Care Coordinator (Remote)

Role Summary

The Care Coordinator I is a key part of the care team based in the Narus Patient Support Center in Nashville, Tennessee. The Care Coordinator I, as a part of the multidisciplinary care team, is responsible for helping patients diagnosed with complex illnesses, recovering from a traumatic clinical event, or managing multiple clinical co-morbidities and providing general member support. This role supports the multidisciplinary team as they develop and manage a comprehensive, individualized care plan for each patient. The care plan helps the patient and their family fully understand their clinical condition, manage symptoms associated with their condition, understand and navigate treatment alternatives, address and assist in navigation of benefits, insurance and billing related issues, claims inquiries, general customer service assistance and address non- clinical issues that impact quality of life and outcomes.

    Daily role responsibilities:

The office-based Care Coordinator I supports the multidisciplinary care team by ensuring seamless delivery of the Narus program for individuals and their families by providing the following services:

• Providing an excellent member experience through direct communication through inbound and outbound calls and secure messages.
• General care coordination duties including.
• Make, change, and confirm office visit appointments with PCPs and specialists.
• Request help from PCPs and specialists with patient demographic data.
• Support the request for clinical service delivery to patient(s) homes, including managing health plan authorization for services.
• Confirm the deployment and receipt of ancillary services such as home health, DME, and community based social services.
• Monitor patients that are hospitalized or in post-acute care for estimated discharge date and scheduling of post-discharge needs.
• Provide assistance and resolve patient issues regarding claims, billing, and payment of healthcare services.
• Educate members on benefits plans including items such as: deductibles, in/out of network inquiries,
• Estimation of benefits (EOB’s).
• Perform appropriate triage and escalation of routine and urgent patient calls to the clinical team when appropriate.
• Calls external facilities and providers to execute on care plan issues for patients.
• Make outbound patient calls to coordinate non-clinical patient needs.
• Assist care team with locating community resources for our patients.
• Assist office-based team with faxing, documentation, and telephonic/virtual support of care management priorities.
• Participate in weekly team meetings.

        This position could be a good fit if you have:

• A minimum of three (3) years of related experience or equivalent, preferably in a physician office or clinical call center.
• High school diploma required.
• Patient, compassionate, and professional personality with a strong service orientation. 
• Demonstrated problem solving skills
• Proficient on Microsoft Office programs, EMR/Care Management platforms, and keyboarding.
• Demonstrated knowledge of legal and ethical issues related to confidentiality, including HIPAA and state specific privacy laws.
• Commitment to excellence and high standards.
• Ability to analyze complex data, draw conclusions, and act on that information in a timely manner.
• Ability to apply problem-solving techniques to the case management process.
• Excellent time management, flexibility, and organizational skills with the ability to work independently.
• Critical thinking and good judgement to quickly determine and prioritize issues
• Good communication, teamwork, and interpersonal skills with the ability to work with all levels of management.
• Prior telephonic patient engagement or care coordination experience preferred.
• Previous experience in medical claims and billing preferred.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. 

Physical and Emotional Demands: 

While performing the duties of this job, the employee is frequently required to sit. The employee is regularly required to stand; walk; use hands to finger, handle, or feel; reach with hands and arms; climb or balance; stoop, kneel, and talk or hear. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, and ability to adjust focus.

Equal Employment Opportunity Policy Statement

Lucent Health Solutions, Inc. is an Equal Opportunity Employer