Care Coordination Specialist - Patient Flow & Insurance

Methodist Le Bonheur Healthcare; Bartlett, Northern (TN, KY); Hybrid; USD 32,000 - 42,000; Full time

Job summary

Methodist Le Bonheur Healthcare in Bartlett, TN seeks an organized clerical professional to maintain the flow of patient information across departments. You will handle referrals, data entry, and insurance verifications while assisting patients and providers with billing and service coordination.

Ideal candidates bring 3–5 years in a healthcare or medical office setting, strong communication, and the ability to work independently under pressure to ensure accurate documentation and timely

Qualifications

• Required - High School Diploma or Equivalent
• Healthcare or medical office environment 3-5 years
• Knowledge of quality and business or office management preferred
• Ability to apply problem solving techniques to assess and interpret medical records to a degree that would support independent work and possess excellent communication skills
• Good customer service skills
• Ability to handle stressful and emotional situations in relationship to patients in acute distress, physicians, or families of dying patients
• Ability to work without close supervision and to exercise independent judgement
• Ability to set priorities, coordinate multiple tasks, organize tasks, maintain workflow, and prepare complex written materials
• Proficiency in database management and word processing
• Knowledge of third party payors as acquired through job experience with insurance customer service or billing

Responsibilities

• Receives referral for services and processes orders from physicians and customers.
• Receives pertinent information on potential patients and contacts appropriate locations and/or departments for services.
• Insures that complete data is obtained from the customer (patient, physician, etc) and completes for submission.
• Identifies additional services/supplies based on patient/customer needs that may be required and makes recommendations.
• Provides customer assistance, including quoting prices.
• Verifies patient/customer insurance coverage with insurance company.
• May negotiate pricing for various services, as determined.
• Obtains a prior authorization/PAR or a certificate of medical necessity/CMN when required by insurance company or payer.
• Offers assistance to patients, patients' families, customers, physicians, and other referral sources that are inquiring.
• Secures all needed data/signatures required to meet payor, state licensure, Board of Pharmacy, CHAP, PHIAA, and FDS requirements.
• Completes "Patient Information Guide", as appropriate.
• Encourages patients/customers to complete "Patient Satisfaction Survey" for quality monitoring purposes.
• Communicates current patient information to appropriate departments and coordinates orders that have been received from referral sources.
• Assists individuals with problems, questions, and concerns regarding programs and services available through HME.
• Enters referrals into computer and updates each entry with corrected data, as indicated.
• Performs other job functions as requested or needed.

Skills

Data entry

Customer service

Communication skills

Problem solving

Independent work

Organization

Education

High School Diploma

Tools

Database management

Word processing

Job description

Methodist Le Bonheur Healthcare in Bartlett, TN seeks an organized clerical professional to maintain the flow of patient information across departments. You will handle referrals, data entry, and insurance verifications while assisting patients and providers with billing and service coordination.

Ideal candidates bring 3–5 years in a healthcare or medical office setting, strong communication, and the ability to work independently under pressure to ensure accurate documentation and timely