The Care Coordinator I will coordinate with physician office staff, patients, and insurance companies to ensure that all types of insurance are verified, and services are authorized. The Care Coordinator I will ensure accurate, prompt, and superior service, answer phones, communicate with all departments and individuals regarding matters related to patient care, and obtain and enter accurate demographic/insurance information for all encounters including patient financial expectations. The Care Coordinator I will prepare referral requests for outpatient services, elective inpatient admissions, skilled nursing facility admissions, durable medical equipment (DME), and home health, utilize health plan websites to obtain benefit verification information and medical necessity criteria, to be utilized by licensed staff to determine the medical appropriateness of the requested service.
Minimum Qualifications:
- Ability to speak and read English at a level that is sufficient to satisfactorily perform the essential functions of the position.
- Knowledge of standard office equipment (i.e., calculator, fax, photocopier) and personal computer and computer software skills (i.e., MS Windows, Excel, Access, Word, PowerPoint, internet, e-mail).
- Windows computer skills including proficient use of keyboarding, use of mouse or keys for functions such as selecting items, use of drop-down menus, scroll bars, opening folders, copying and similar operations required upon employment or within the 1st two weeks of employment to perform the essential functions of the job.
- Performs other duties as assigned.
- Follows Palomar Health Medical Group rules, policies, procedures, applicable laws, and standards.
- Carries out the mission, vision, and quality commitment of Palomar Health Medical Group.
Minimum Education: High School or equivalent
Preferred Education: Medical Administrative or Insurance Specialist Certified
Minimum Experience: 0-12 months in the medical field or Managed Care setting
Preferred Experience: 2 Years in healthcare setting
Required License: Not Applicable
Preferred License: Not Applicable
Required Certification: Not Applicable
Preferred Certification: Medical Administrative or Insurance Specialist Certified
#J-18808-Ljbffr
