Care Coordination Associate

Job Description

Job Description

Overview

Join a Team That Changes Lives

For more than 170 years, Elwyn has been leading the way in supporting children, teens, and adults with autism, intellectual and developmental disabilities, and behavioral health challenges. As a mission-driven nonprofit, we’re here to create real change – helping people lead meaningful, fulfilling lives.

Now, we’re looking for passionate team members to join us. Here, your work will change lives – including your own. You’ll make an impact every day, find purpose in what you do, and grow in a career that truly matters.

At Elwyn, we take care of you while you care for others. We offer:

• Generous Paid Time Off
• Comprehensive Medical/Dental/Vision Benefit Packages
• Earned Wage Access/On-Demand Pay
• Paid On-the-Job Training
• Tuition Reimbursement
• Career Advancement Opportunities and Growth
• Flexible Schedules
• Retirement Savings Plan

Join us and be a part of something bigger. Apply today.

Responsibilities

POSITION SUMMARY: The Care Coordination Associate (CCA) organizes and manages health information data by ensuring its quality, accuracy, accessibility, and security in both paper and electronic systems. Maintains the Electronic Health Record (EHR) and ensures that client information is entered and updated in a timely manner. Schedules client appointments and ensures that medical records are appropriately routed to physicians, emergency departments, hospitals, and other health care providers. Ensures that all data exchange meets the legal requirements of Health Insurance Portability and Accountability Act (HIPAA) and protects client rights.

DUTIES & RESPONSIBILITIES:

• Responds promptly and professionally to all forms of communication including but not limited to phone calls, email, fax, e-HR notifications regarding medical appointments and care coordination to ensure continuity of care
• Verifies client insurance eligibility based on insurance eligibility documentation routinely as they schedule appointments by reviewing and utilizing the electronic health records; contacts insurance carriers as needed to ensure appropriate care can be secured
• Updates and monitors electronic health records system to ensure compliance of all medical appointments
• Acquires insurance referrals and pre-authorizations as needed from the carrier for appointments to be scheduled requesting assistance from Nurse Case Managers and Program leads as needed to ensure continuity of care
• Obtains necessary paperwork for durable medical equipment as required for payment by the insurance provider including but not limited to obtaining the prescription, any pertinent information from a Primary Care Physician (PCP) or hospital; follow-up with insurance provider as needed to ensure care continuum
• Prepares reports relative to regulatory standards by ensuring required medical/dental/lab appointment reports are collected and maintained, such as Primary Care Physician (PCP) visits, lab testing and results, emergency department visits, hospitalizations, and required health maintenance visits to ensure care coordination; presents reports to the direct supervisor for system compliance review
• Tracks medical appointments and labs for assigned caseload by running status reports within electronic health records to ensure that all required and recommended medical follow up appointments, treatments and diagnostic studies are scheduled and completed within the allotted regulatory timelines
• Tracks medical documentation of all encounters with medical providers for assigned caseload to ensure that the associated documentation reaches the responsible staff and that they are aware of the requested follow up for continuity of care
• Supports the program to ensure the individual and staff are prepared for individual medical appointments for their assigned caseload with tasks including but not limited to validating insurance information prior to the visit, confirming that all necessary pretesting (laboratory tests, x-rays, diagnostic studies, etc.) has been performed and results received and forwarded, ensuring that the Medical Appointment Summary form is initialized for each visit and compiling the packet of required paperwork for the visit and providing to the site supervisor
• Schedules medical appointments with PCP, specialists, and other applicable allied health professionals based on the program medical appointment schedule, requests from a nurse or program manager, or a previous Medical Appointment Summary reflecting the physician's note to ensure the ongoing health and safety of each individual
• Obtains consultative, diagnostic, and other clinical reports and submits to the assigned nurse and other health care providers on the clinical team to ensure continuity of care, identification of additional healthcare and other needs
• Performs other work as assigned

EDUCATION/ EXPERIENCE/SKILLS REQUIREMENTS :

• Associate degree in Human Services, or a healthcare related field preferred; high school diploma or graduate equivalency diploma (GED)
• Experience in a large multi-specialty physician practice or healthcare setting preferred
• Possess working knowledge of medical terminology and basic clinical knowledge such as International Classification of Diseases (ICD-coding), Diagnostic and Statistical Manual of Mental Disorders (DSM)
• Knowledge of medical insurance coverage plans preferred
• Intermediate experience in the use of standard Microsoft Office Word, Excel, Outlook and Teams (or other virtual meeting applications, e.g., Zoom, etc.)
• Demonstrated skills in the use of the EHR, including, maintenance and reporting capabilities.
• Excellent planning, organizational, and written and spoken communication skills
• Possesses strong customer service orientation, the ability to multitask, and close attention to detail
• Ability to work in a fast-paced environment and manage and prioritize multiple, often competing priorities
• Ability to request, accept and utilize feedback and training appropriately
• Ability to provide effective feedback, train and delegate job assignments
• Demonstrated commitment to standards of excellence that demonstrate an overall concern for quality of work, communication, and commitment to doing what is best for the organization
• Demonstrated ability to work as an efficient and effective member of a team
• Must possess a current, valid driver's license in state of residence, have a minimum of two (2) years of driving experience within the United States, and have an acceptable driving record