Care Coordinator - Auth - Scheduling Specialist

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

Job Summary

Assists patients and providers with coordinating of referrals, obtaining authorizations and scheduling. This position is also responsible for understanding benefits coverage and ensures patient's care is coordinated.

Essential Functions

• Completes referrals for patients and coordinates with referring and receiving practices and/or departments.
• May coordinate and prepare 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.

Physical Requirements

Must be able to sit for long periods of time and work in a fast-paced office environment. Should be able to bend and lift up to 10 lbs.

Education, Experience and Certifications

High School Diploma or GED required. Computer experience required. Thorough understanding of Insurance coverage (FSC/Coverage/Plan types) and Medical Necessity policies preferred. Knowledge of medical records software preferred. Customer service experience required.