PATIENT CARE SPECIALIST

Sun-Life-Health; Casa Grande (AZ); On-site; USD 38,000 - 48,000; Full time

Job summary

Sun-Life-Health is seeking a patient care specialist in Casa Grande, AZ to manage in-office testing authorization and scheduling. The role involves coordinating with insurance carriers, documenting services in the EHR, and ensuring timely patient follow-up across the care continuum.

Ideal candidates will have a High School Diploma (or equivalent) and healthcare reception experience. This full-time position emphasizes collaboration with care teams and patient-centered service.

Qualifications

• High School Diploma or equivalency preferred.
• Experience as a receptionist in a health care setting preferred.

Responsibilities

• Obtain authorization for in-office testing from insurance carriers and transmit instructions to obtain authorization.
• Schedule patients for testing after authorization is received.
• Document patient services in Sun Life’s EHR and track pending authorizations to ensure timely completion.
• Facilitate rescheduling of testing and manage no-shows with proper documentation.
• Enter orders so testing reports can be reviewed by the provider efficiently.
• Maintain cooperative relationships among health care teams and communicate requests as needed.
• Refer patients to Outreach if sliding fee eligibility or payor changes are identified.
• Run monthly reports to confirm patient appointments and use eCW registry reporting for high-risk patients.

Education

High School Diploma or equivalency

Job description

STATEMENT OF PURPOSE:The patient care specialist facilitates all aspects of patient activities as a collaborative effort across the heath care continuum. The patient care specialist will ensure that our patients receive the appropriate in-house testing and follow up as recommended by the Center for Women providers. This patient-centered approach will allow for a centralized approach to meeting our patients’ needs.ESSENTIAL FUNCTIONS:Obtain authorization for in-office testing (i.e. ultrasounds and non-stress tests) by contacting the appropriate insurance carrier, communicating the provider's instructions, and transmitting information as needed to obtain authorizationCommunicate with and schedule patient once authorization is received for in-office testingClearly document patient services as related to insurance approvals and patient communications in appropriate location in Sun Life’s EHRTrack pending authorizations and patients that have yet to be scheduled as to ensure all tasks are completed for each patient in a timely mannerFacilitate rescheduling of testing as needed by patientsReview, contact, and reschedule “no shows” for testing with appropriate documentationEnter orders so the testing reports can be reviewed by the provider efficientlyMaintain a cooperative relationship among health care teams by compiling statistics, communicating information, responding to requests, building rapport and participating in problem-solving methodsRefer patient to Outreach department if eligibility for sliding fee is identified or if a change in payor source is identified to align resources with patient and population needsRun reports monthly to confirm patient appointmentsMake use of eCW registry reporting to track all high-risk patients to maintain quality and reduce gaps in careManage MFM ReferralsPlace ultrasound ordersAttach ultrasound reports to patient’s chart eCW.Any other tasks designated by supervisorEDUCATION AND EXPERIENCE:High School Diploma or equivalency preferredExperience as a receptionist in a health care setting preferred