JOB SUMMARY: The patient care coordinator works in collaboration with patients, care givers, clinic/hospital providers and staff using a team based approach to promote timely access to appropriate care, assist in utilization of preventative care services, reduce emergency room utilization and MMHS readmission, assist patients navigate through healthcare services/needs with the goal of improving health and wellbeing, increase patient satisfaction and reduce health care costs. Performs a variety of clerical and/or receptionist duties relating to patient registration and insurance verification for the Medical Clinic. Responsible for appointment scheduling and verification, answering phones and taking messages, data entry, completion/verification of patient registration, verification of insurance, collection of payments, and credit card processing.
PERFORMANCE DIMENSIONS AND TASKS
Essential Function
A. Population Health Management
1. Assist in population health management by identifying, tracking and scheduling follow up care for patients discharged from inpatient service at this and other facilities.
2. Identify populations due for preventive or chronic care outpatient services.
a. Run reports as needed (daily, weekly, monthly, quarterly) of preventive and chronic care that is due for population health management (e.g., well child visits, diabetes care, colorectal screening, etc.)
b. Complete outreach to patients to schedule/notify of appointments.
c. Sends letters to patients that are not reached by phone.
d. Adding and Removing Alerts.
3. Ensure documentation is in patients’ electronic charts by time of office visit.
4. Assist in managing a highly reliable system for closing the loop on patient appointments for tracking population health management.
B. Essential Functions
1. Verifies insurance coverage.
a. Always verifies insurance information: private Medicare or Medi-Cal.
2. May attend to administrative needs of patient/family: (explains charges, alternatives for payment of bill).
a. Responds with sensitivity to patients and family in matters related to money and personal areas.
b. Is able to give basic information in response to most questions regarding patient bills/insurance.
c. Consistently able to acquire insurance information and reviews with patient to ensure accuracy.
d. Consistently/accurately files all material during assigned shifts.
e. Communicates to supervisor any customer/patient complaints.
3. Operates clinic telephone extension.
a. Answers telephone in a courteous manner.
b. Identifies self and uses correct English when communicating.
c. Pages in a clear, well modulated voice to ensure understanding.
d. Demonstrates efficient, proper use of phone and paging system.
e. Does not use switchboard for personal calls.
f. Responsible for all emergency code calls; responds with expediency and efficiency.
4. Performs miscellaneous clerical duties to support billing activities.
a. Typing is current; typing is accurate and completed bills are technically correct.
b. Files materials accurately; all files can be retrieved in 3 minutes.
a. Willing to learn new jobs and assist others.
b. Consistently attends department meetings.
c. Accurately performs verification of INS, including Medi-Cal.
5. Attend and actively participate in Outpatient Quality and Population Health meetings.
6. Run reports to identify opportunities to improve quality measure performance.
7. Performs other duties as assigned .
QUALIFICATIONS
Education:
• Certified medical assistant - required
Work Experience:
• Knowledge of office organization and basic clerical skills
• Knowledge of EMR - preferred
• Background and experience with computers including Microsoft Word and Excel programs
• Basic knowledge of insurance billing - preferred
• Medical terminology - preferred.
Licensing Requirements:
• None
Language Requirements:
• Bilingual (English/Spanish)
Physical Demands:
• Must be able to sit up to 8 hours and stand/walk up to 4 hours per day.
• Must be able to lift and push/pull up to 35 pounds.
• Must be able to use repetitive hand to finger dexterity motion.
• Must be able to speak and hear.
Special Demands:
• Willing to perform repetitive tasks.
• Ability to work with others and to perform a variety of assigned tasks.
DISCLAIMER: The preceding job description has been designed to indicate the general nature and level of work performed. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this job.
