Patient Care Coordinator

United Health Centers; Fresno (CA); On-site; USD 33,062,000 - 34,220,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Paid Time Off

401k Plan

Educational Assistance

Employee Discounts

Job summary

United Health Centers in Fresno, CA is seeking a Patient Care Coordinator to assist patients with Medi-Cal enrollment and other health plans, and to schedule follow-up care for continuity of care after discharge from hospital.

The role focuses on delivering excellent customer service, guiding patients through insurance options, and helping with eligibility and monthly premium estimates while maintaining HIPAA compliance.

Qualifications

• Associate degree in business administration or related field.
• Bachelor's Degree preferred in Business Administration or related field.
• Two years health plan enrollment experience preferred.

Responsibilities

• Deliver enrollment services to patients and assist with Medi-Cal enrollment.
• Assist applicants with completing applications and explaining required documents.
• Verify and update insurance and demographic information for UHC health services.
• Screen and determine eligibility for Medi-Cal, Family PACT, CDP, Covered California, and other programs.
• Maintain confidentiality of all applications and records.
• Provide outstanding customer service to internal and external customers.
• Coordinate follow-up care and scheduling for continuity of care after discharge.

Skills

Bilingual

Communication skills

EMR system

Revenue cycle

Medicare knowledge

Education

Associate degree in business or related field

Bachelor's Degree Preferred

Job description

The Patient Care Coordinator is a Non-Exempt position and reports to the Enrollment Manager. The Patient Care Coordinator is responsible to assist patients in enrollment into Medi-Cal or other health plans that will assist with health care cost. In addition, the Patient Care Coordinator is responsible to assist the discharged patient in scheduling the follow-up care at a UHC health center for continuity of care. The Patient Care Coordinator will deliver their services with excellent customer service and courtesy to all patients preparing for discharge from the hospital. The individual in the position will provide information and education about their health coverage. The Patient Care Coordinator will be responsible for assisting the discharged patient in navigating through health care issues, such as changing primary care physicians, issues with Medi-Cal benefits, etc.

SUMMARY OF RESPONSIBILITIES

This position is directly responsible for supporting the hospital by reducing the reoccurrence of in-patient admissions or the use of the emergency room. Additionally, the position is responsible for improving patient’s health outcomes by assisting the patient in accessing follow-up care at UHC and establishing care at UHC. The Patient Care Coordinator will be responsible to/for

• Schedules follow-up care, educates, registers, verifies and estimates services for the patient, updates insurance and demographic information for all UHC health services
• Screening and evaluating to determine a patient's eligibility for Medi-Cal, (including Medi-Cal Dental and Presumptive Eligibility), Family PACT, CDP, Covered California and Sliding Fee Program, or any other program that may assist our patients financially.
• Assist applicants in properly completing the application and answering their questions.
• Ensure the confidentiality of all applications, records, and any information received in written, graphic, oral, or other tangible forms.
• Review and explain the documents that are required with the application.
• Refer applicants, when necessary, to the county Department of Social Services (DSS) for Medi-Cal if they need more information or assistance with complex issues or other programs
• Assist applicants in estimating their monthly premiums.
• Overall knowledge of the revenue cycle process, registration, insurance verification, precertification, billing compliance, payer contracts, patient estimation, financial assistance.
• Promptly and courteously answers and screens phone calls for the department; routes call as appropriate within established customer service guidelines; accurately records messages and delivers to the appropriate party in a timely manner; checks voicemail frequently.
• Maintains their patient schedule to ensure maximum production of enrollment applications and patient referrals.
• Provides outstanding customer service to internal and external customers.
• Reports any potential customer concerns or complaints immediately to Enrollment Manager and Director of Billing.
• Review enrollment documentation to ensure that they are prepared properly and follow-up when necessary.
• Must build community long term relationships to ensure future enrollment engagement and opportunities.
• Fosters an environment that promotes teamwork and positive communications within the service area and department.

PERFORMANCE AREA 1 Primary Work Duties

• Deliver enrollment services to patients.
• Supports the functions of the hospital by ensuring that collection and data entry of patient information.
• Assists with the development of policies/processes of enrollment departments.
• Ensures compliance of UHC policies and procedures.
• Carrying a caseload and provides timely and accurate record keeping and reports as required for assisting patients.
• Reconciles and ensures capture of necessary data for reporting and system processes on a monthly basis.
• Supports the work of the area by being able to multitask and manage multiple assigned projects and meet assigned deadlines.
• Participates in continuous quality improvement by identifying areas of opportunity and initiating necessary actions and innovation.
• Responding immediately to patient concerns and/or complaints in a courteous manner. Ensures that all patients are treated in a friendly and highly-effective manner and develops high expectations of customer service.
• Working collaboratively with the Enrollment Manager to address concerns with the hospital, UHC sites, directors/managers/supervisors, physicians, and patients.
• Follows chain of command.

PERFORMANCE AREA 2 General Corporate Expectations

• Attends and actively participates in all meetings (e.g., department meetings, program meetings, employee staff meetings) and other activities as required or assigned.
• Attends workshops/seminars as necessary to increase skills and knowledge to provide effective care, treatment, and/or leadership.
• Supports the overall needs of the health center by working flexible or extended hours when necessary.
• Supports the needs of the health center by traveling to other health centers when staffing needs dictate.
• Demonstrates awareness of, and compliance with, organizational mission and objective of UHC to provide health care access and support services for all members of the community.
• Other work-related duties as assigned by supervisor. Duties and responsibilities may be added, deleted, or changed at any time at the discretion of management, formally or informally either verbally or in writing.
• Maintains confidentiality and respect for information regarding patients and other team members; abides by UHC Rules of Confidentiality and general HIPAA regulations regarding privacy.
• Supports their own staff development by completing the required hours of continuing education each year.
• Displays a positive, professional and respectful demeanor at all times toward employees, peers, professional contacts, and patients served, maintaining a professional appearance and positive image for the health centers.
• Contributes to the team by promoting positive staff interaction, maintains open communication with other programs/departments.

QUALIFICATION REQUIREMENTS

EDUCATION

• Associate degree, preferable in business administration or related field or equivalent years of experience.
• Bachelor's Degree Preferred - in Business Administration or Management Operations.

PRIOR EXPERIENCE

• Two (2) years health plan or State funded program enrollment experience, preferred.
• A combination of education and experience will be considered.

Skills

• Bilingual required.
• Clear verbal and written communication skills.
• Prior experience with an electronic medical record system required.
• Thorough understanding of medical billing, collections and payment posting, revenue cycle, third party payers, Medicare; strong knowledge of California and Federal payer regulations.
• Sufficient knowledge of policies and procedures to accurately answer questions from internal and external customers.
• Possess excellent negotiation skills, including the tact required for securing payment or discussing patient's finances, and enjoy working in a health care setting.
• Able to handle multiple tasks simultaneously.

Physical Requirements

• Must be able to lift up to 20 pounds and push up to 50 pounds (on wheels).
• Must be able to hear staff on the phone and those who are served in-person, and speak clearly in order to communicate information to patients and staff.
• Must be able to read memos, computer screens, personnel forms and clinical and administrative documents.
• Must have high manual dexterity.
• Must be able to reach above the shoulder level to work, must be able to bend, squat and sit, stand, stoop, crouch, reach, kneel, twist/turn

The hourly wage range that UHC reasonably expects to pay for the position upon hire starts at $24.20 an hour. Our salaries are dependent on knowledge, skills, and experience.

In addition, our comprehensive benefits package for regular status employees includes

• Medical, Dental, and Vision insurance with low premium cost
• Paid time off and paid holidays
• 401k plan with matching contribution
• Educational Assistance
• Employee discounts and more!