Patient Care Coordinator

California Specialty Pharmacy,LLC; Whittier (CA); On-site; USD 45,000 - 60,000; Full time

Job summary

California Specialty Pharmacy, LLC is seeking a Patient Care Coordinator to process referrals, verify insurance benefits, and coordinate with Pharmacy, Delivery, Billing, and Nursing to ensure timely patient service.

You will answer phones, assist with scanning and assigning patient records, follow up on authorizations and nutrition referrals, and maintain accurate documentation. Bilingual in Spanish is highly preferred, and solid medical terminology and office skills are essential.

Qualifications

• High school diploma or equivalent.
• Bilingual in Spanish is highly preferred.
• Strong knowledge of medical terminology.
• Experience with medical coding is a plus.
• Proficient in office software and general computer skills.

Responsibilities

• Process patient referrals, collect required clinical documentation, verify insurance, coordinate pre-collections and services.
• Answer telephones and coordinate with all departments.
• Organize and maintain timely follow-up for nutritional consults.
• Process patient and physician mail correspondence.
• Assist with scanning and assigning all patient records.
• Verify insurance for patient add-ons each morning and communicate changes.

Skills

Bilingual in Spanish

Medical terminology

Effective time management

Organizational skills

Office and computer skills

Education

High school diploma

Tools

Electronic Health Records (EHR) system

Medical coding software

Job description

Description of Responsibilities

The Patient Care Coordinator is responsible for processing patient referrals efficiently and in a timely manner. Coordinator will also verify insurance coverage and benefits with pre-collections if needed. Coordinator is also responsible for answering telephones and coordinating with all departments. Coordinator will also assist with scanning and assigning of patient records. Coordinator will also perform miscellaneous tasks including patient follow up calls as needed.

Reporting Relationship

This position reports to the Director of Operations. In the absence of the Director of Operations: Lead Patient Care Coordinator

Scope of Supervision

None

Responsibilities of the Patient Care Coordinator – Patient Care Coordinator include the following:

• Process patient referrals, collect required clinical documentation, verify insurance, coordinate pre-collections and nursing, and coordinate services such as PICC placements and speech evaluations.
• Answer telephones and coordinate with all departments.
• Organize and maintain timely follow-up for nutritional consults.
• Process patient and physician mail correspondence.
• Assist with scanning and assigning all patient records.
• Verify insurance for patient add-ons each morning within one hour or before delivery; communicate changes to Delivery, Billing, and Pharmacy, and update the patient file.
• Remain current on insurance contract and company changes, including which party is at risk for payment.
• Contact physician offices, home health agencies, and patients to obtain patient information, insurance information, and updated clinical documentation.
• Monitor incoming faxes throughout the day and direct them to the correct recipients.
• ACCOUNTABILITIES AND PERFORMANCE MEASURES
  • Check and respond to all pertinent emails relating to patient care throughout the day.
  • Respond promptly to all referral sources within the allotted time.
  • Track all referral sources throughout the day, including faxes, and emails.
  • Ensure patient copays are collected upon delivery; when payment is not collected, follow up with the patient.
  • Track and ensure all pertinent patient documents are signed and returned; follow up with the patient when documents are outstanding.
  • Assist with treatment approval by obtaining all pertinent clinical documentation needed for authorization submission.
  • Maintain effective communication with Pharmacy and Delivery, especially for time-sensitive referrals.
  • Follow up with WPCs to ensure referrals are processed or cancelled.

Qualifications and Preferred Skills

• High school graduate.
• Office and computer skills.
• Knowledge of medical terminology.
• Medical coding experience.
• Effective time-management and organizational skills.
• Bilingual in Spanish. (Highly Preferred)

Physical Requirements

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions in this job description:

• The employee is regularly required to stand, walk, and sit, as well as talk and hear.
• The employee is required to use hands to operate office equipment.
• The employee must occasionally lift and/or move up to 60 pounds.
• Specific vision abilities required by this job include close vision, distance vision, peripheral vision, and the ability to adjust focus.