Specialty Care Coordinator

Ridgeview Medical Center; Waconia (MN); On-site; USD 42,000 - 62,000; Full time

Job summary

Ridgeview Medical Center in Minnesota seeks a Specialty Care Coordination professional to manage referrals, prior authorizations and serve as liaison among plans, patients and providers. You will coordinate registrations, schedules, and insurance actions while supporting medical information requests.

The role requires healthcare experience, strong communication, and the ability to multi-task within a complex care environment.

Qualifications

• High School diploma or equivalent.
• Strong customer service experience.
• Attention to detail.
• Two years' healthcare experience.

Responsibilities

• Assures accurate processing of patient registration.
• Accurately schedules patient appointments according to clinic policy.
• Coordinates insurance referral actions and pre-certifications.
• Coordinates care with Ridgeview Patient Financial Services.
• Coordinates requests for release of medical information.
• Assists with coordination of completion of medical forms.
• Liaises between patients, insurance company and provider.
• Coordinates staff coverage for current and upcoming shifts.
• Coordinates inpatient and outpatient services including imaging, lab, procedures, surgeries.
• Ensures documentation, coding and billing for each service.
• Collects and reports statistics as needed.
• Performs administrative support duties.
• Performs other duties as assigned.

Skills

Healthcare experience

Multi-tasking

English communication

Basic math

Teamwork

Medical terminology

ICD-10 coding

Office software

Education

High School diploma or equivalent

Nursing Assistant / CMA / LPN

Tools

Microsoft Office

Job description

Purpose of the Job

This position is responsible for the coordination of Specialty Care patients, managing requests for incoming and outgoing referrals and prior authorizations. Acts as a liaison between health plans, patients and providers.

Job Functions

1. Assures accurate processing of patient registration.
2. Accurately schedules patient appointments according to clinic policy.
3. Coordinates insurance referral actions and pre-certifications.
4. Coordinates care with Ridgeview Patient Financial Services.
5. Coordinates requests for release of medical information.
6. Assists with coordination of completion of medical forms.
7. Responsible for self-education to keep informed of changes within the care system guidelines.
8. Serves as a liaison between patients, insurance company and provider.
9. Coordinates with the Clinic Staffing Department coverage for current and upcoming shifts based on established guidelines and needs.
10. Coordinates inpatient and outpatient services including imaging, lab, procedures, surgeries, etc.
11. Ensures that all Specialty Care services have been captured and that documentation, coding and billing has been completed for each service.
12. Collects and reports statistics as needed.
13. Performs administrative support duties as needed.
14. Performs other duties as assigned.

Employment Requirements

Minimum Education/Work Experience

• High School diploma or equivalent
• Strong customer service experience
• Attention to detail
• Two years' healthcare experience

Knowledge/Skills/Abilities

• Ability to multi-task
• Ability to meet and maintain the necessary background checks as aligned with position functions
• Ability to communicate in the English language for effective written and verbal correspondence in order to complete job functions as mentioned above
• Ability to perform basic math functions and count money
• Ability to serve patients in a friendly and efficient manner
• Knowledge of basic computer functions and Microsoft Office applications
• Ability to respond appropriately to unpredictable situations and diverse patient populations
• Ability to work autonomously and as a team
• Capable of making independent decisions with the use of good critical thinking and problem-solving skills
• Knowledge of Medical Terminology
• Knowledge of ICD-10 coding
• Ability to prioritize workload according to medical necessity
• Ability to communicate in the English language for effective written and verbal correspondence in order to complete job functions as mentioned above

Preferred Qualifications

• 2+ years of experience in specialty
• Nursing Assistant, CMA or LPN

Compensation

Many factors are taken into consideration when determining compensation such as: the requirements of the position, experience, education, knowledge, and skills along with location and internal equity. Pay listed does not include any shift, weekend, or other differentials.

Benefits

Ridgeview strives to provide comprehensive and market competitive benefits to meet the needs of our employees and their families.