Patient Care Coordinator

GENERAL DESCRIPTION OF POSITION

The Patient Care Coordinator is an integral part of the Rheumatology team, focusing on a seamless patient experience by assisting in the financial responsibilities of the patient, and offering the ultimate patient experience at the check-in desk.

• Greet every patient with a warm and friendly smile.
• Efficiently check patients in and out.
• Collect copays, any outstanding balances, and verify referrals when needed.
• Update and add patient demographics as required.
• Build insurance packages and complete any necessary paperwork.
• Gather and organize charge tickets; fax and scan them.
• Responsible for the infusion authorization/precertification process to include coordinating with outside and internal organizations along with insurance companies to ensure prior approval requirements are met. Presents necessary medical information such as history, diagnosis, and prognosis. Provides specific medical information to financial services to maximize reimbursement to the providers.
• Verifying benefits and eligibility for both new and existing patients to process patient benefits in a timely manner.
• Calculates patient due portions based on insurance verification.
• Communicates with patients on their payment expectations.
• Understanding insurance carriers and concepts including drug cards, major medical and pharmacy benefits, and knowledge of government and patient assistance programs
• Validating patient copay assistance programs
• Processing all outside infusion referrals
• Reviewing payment records for patients and third parties, ensuring fees are collected properly.
• Answering phone calls and returning voicemails in a timely manner
• Checking and resolving assigned tasks in Electronic Health Record
• Determine if services are covered under the patient's insurance plan.
• Educate patients about payment options and financial assistance.
• Handle inquiries related to patient accounts from both staff and patients.
• Ensure effective communication with clinical staff regarding late patients and any factors that may delay patient readiness.
• Perform other related duties as required or assigned.

QUALIFICATIONS

• High school diploma or equivalent required.
• Minimum of 1 year experience in customer service role.
• Previous experience in financial counseling, medical billing, or related areas is advantageous.
• Excellent verbal and written communication.
• Proficient in using standard office software (Microsoft Office Suite).
• Familiarity with electronic health records (EHR) systems is a plus.