Patient Access and Care Coordination Specialist

Socket.dev; Franklin (TN); On-site; USD 38,000 - 60,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Disability insurance

Group term life

Generous PTO Policy

Employee recognition programs

Office amenities

Regular employee events

Job summary

Prime Health Services is hiring a Patient Access and Care Coordination Specialist to schedule appointments and keep case status current. You will also manage patient financials and coordinate referrals to external providers as needed.

Role requires strong organization, attention to detail, and the ability to work in a fast-paced environment. Bilingual English/Spanish is preferred to support diverse clients and patients.

Qualifications

• High School Diploma or equivalent with 2 years of healthcare/claims experience.
• Associate degree in business or related field preferred.
• Medical Assistant certification preferred.
• Prior scheduling, billing, and insurance verification experience preferred.
• Proficiency with Microsoft Office (Excel, PowerPoint, Word, MS Teams).
• Bi-lingual English and Spanish preferred.

Responsibilities

• Schedule medical appointments in scheduling tool per client/patient requests.
• Update case status and client on financial allotments and progress.
• Refer out-of-network providers to negotiate and contract within network.
• Assist non-English speaking patients using language services as available.

Skills

Microsoft Office

Excel

PowerPoint

Word

MS Teams

Bi-lingual English/Spanish

Education

High School Diploma or GED

Associate's degree preferred

Medical Assistant certification preferred

Tools

MS Office Suite

Job description

Description

The Patient Access and Care Coordination Specialist works collaboratively with clients and patients to ensure the timely scheduling of Patients’ appointments consistent with their requests and defined treatment plan.

What You’ll Do

• Schedule medical appointments in the PHS scheduling tool as requested and directed by PHS Clients and the referred patients in a timely manner
• Update case status in the PHS scheduling tool with accurate and current information
• Update Client regarding status (balance of dollars allotted to each case) when patient expenses are nearing the maximum allotment to receive direction as to next steps, i.e. increase allotted dollar amount assigned to the case or close the case
• Refer out-of-network providers to the Provider Negotiation Specialist to obtain a single case agreement and to the Provider Contracting team to contract the provider to the PHS network
• Service non-English speaking patients/Clients by using the contracted language services company and/or other bi-lingual team members as available

Requirements

What We’re Looking For

• High School Diploma or equivalent (GED) and 2 years of experience working in a healthcare, insurance, claims processing, and/or medical billing/pricing setting
• Associate's degree in business or related field of study from an accredited college or university is preferred
• Certification from a recognized Medical Assistant training program is preferred
• Prior patient scheduling, billing, and insurance verification experience is preferred
• Demonstrated proficiency in Microsoft Office – Excel, PowerPoint, Word, MS Teams
• Bi-lingual in English and Spanish is preferred based on business needs

Competencies

• Detail focused and the ability to multi-task and adhere to established goals
• Ability to work in a fast paced, changing environment; flexible to meet business needs
• Results driven team player
• Ability to maintain confidential information as required
• Excellent communication skills (oral and written)
• Superb organizational, problem solving, and time management skills
• Ability to maintain a calm and professional demeanor in stressful situations

Why You’ll Love Working at Prime Health Services

• Medical Insurance (high deductible plan with an HSA)
• Dental Insurance
• Vision Insurance
• Short-term and long-term disability paid by the company
• Group term life paid by the company
• Generous PTO Policy
• Employee recognition programs with monetary rewards
• Corporate office amenities
• Regular employee events

About Us

Prime Health Services (PHS) is a national medical cost containment company with a noteworthy PPO Network used by insurance carriers, TPA’s, self-insureds, and governmental entities. Our tech-focused nature allows clients to take advantage of the flexibility of customization while not compromising on bill processing speed. Since 2001, we have specialized in medical provider network development and offer clients a tailored approach to medical cost containment: quality health care at discounted rates.