Care Coordination Specialist: Referrals & Benefits

Advocate Health; Charlotte (NC); On-site; USD 45,000 - 65,000; Full time

Job summary

Advocate Health in Charlotte, NC seeks a Care Coordination Specialist to assist patients and providers with referrals, authorizations, and scheduling, while understanding insurance benefits and ensuring care is coordinated.

You will work across departments to coordinate referrals, obtain authorizations, explain coverage to patients, and follow up to prevent gaps in care; strong computer skills and customer service are essential.

Qualifications

• Must have a high school diploma or GED and computer proficiency.
• Strong understanding of insurance coverage and medical necessity policies.
• Experience with medical records software and customer service is required.

Responsibilities

• Completes referrals for patients and coordinates with referring and receiving practices and/or departments.
• Coordinates and prepares financial estimates for patients.
• Obtains all authorizations needed.
• Directs patients to providers in their insurance plan.
• Reviews benefits and educates patient on insurance coverage.
• Coordinates and schedules surgical procedures, diagnostic testing, or other services within various departments with internal and ancillary providers.
• Reviews schedules and confirms schedules are accurate and time is properly allocated.
• Follows up on all referrals to ensure no care gaps.

Skills

Customer service

Computer experience

Insurance coverage knowledge

Medical necessity policies knowledge

Education

High School Diploma or GED

Tools

Medical records software

Job description

Advocate Health in Charlotte, NC seeks a Care Coordination Specialist to assist patients and providers with referrals, authorizations, and scheduling, while understanding insurance benefits and ensuring care is coordinated.

You will work across departments to coordinate referrals, obtain authorizations, explain coverage to patients, and follow up to prevent gaps in care; strong computer skills and customer service are essential.