Care Coordination Specialist

AbsoluteCARE Medical Center & Pharmacy; United States; Remote; USD 40,000 - 65,000; Full time

Job summary

An innovative healthcare organization is seeking a Care Coordination Specialist to enhance the patient experience through effective management of specialist referrals. This role focuses on ensuring seamless communication between patients and specialists while maintaining compliance with healthcare regulations. Ideal candidates will possess strong organizational and communication skills, along with a passion for improving healthcare delivery. Join a forward-thinking team dedicated to making a difference in patient care and enjoy the flexibility of a remote work environment.

Qualifications

• 2-3 years of experience with insurance verifications and benefits preferred.
• Strong attention to detail and ability to multi-task effectively.

Responsibilities

• Manage the care coordination process for specialist referrals and ensure follow-up.
• Provide excellent customer service and communicate effectively with patients.

Skills

Insurance Verifications

Customer Service

Communication Skills

Microsoft Office

Medical Terminology

Education

High School Diploma

Job description

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Job Summary

This role is responsible for managing the care coordination process surrounding specialist referrals for patients, ensuring appropriate communication is provided to the specialist and the patient, as well as ensuring follow-up information is received from the specialist for the referring provider to review. This role will gather, process, and maintain patient medical records in a manner compliant with ethical, legal, and regulatory requirements.

Duties And Responsibilities

1. Monitor the referral management system for new referral requests, monitor referrals in progress, and complete documentation in the referral process.
2. Provide patients with verbal and written instructions, preferably electronically, along with any specific instructions or requirements from the specialist.
3. Monitor changes in PCP assignment that could invalidate existing referrals and handle appropriately.
4. Ensure patients are seen by the specialist, rescheduling when necessary.
5. Provide excellent customer service, ensuring patients have necessary information and assisting in coordination of referrals.
6. Communicate with the care team about patient appointment refusals or no-shows.
7. Follow up with specialists post-appointment to obtain documentation if not received, as referrals may not be complete until documentation is received.
8. Troubleshoot and alert providers or management of coverage issues or barriers to scheduling.
9. Relay coverage information to patients.
10. Maintain knowledge of insurance plans, referral requirements, eligibility, copayments, coinsurance, deductibles, pre-existing conditions, and plan limitations.
11. Prioritize patient and physician needs effectively based on triage knowledge.
12. Supply staff with required forms and documents.
13. Protect medical records from loss or damage before the end of retention periods.
14. Process records accurately and timely.
15. Maintain strict confidentiality of all medical records.

Minimum Qualifications

1. High school diploma or equivalent.
2. 2-3 years’ experience with insurance verifications and benefits preferred.
3. Passion to improve healthcare delivery.
4. Ability to multi-task, be highly organized, and possess excellent communication and customer service skills.
5. Proficiency in Microsoft Office.
6. Strong attention to detail.
7. Knowledge of medical terminology.

Working Conditions

This is a remote role requiring a dedicated, quiet workspace and adherence to HIPAA and other privacy policies. Reliable high-speed internet is necessary.

Physical Requirements

• Clear communication skills.
• Ability to remain stationary for long periods.
• Operate computer, keyboard, phone, and office equipment.

Direct Reports

None.