Patient Case Manager

Description:

IMA Patient Care Coordinator Job Description #PGM26

Department: Scheduling – Business Office

Supervisory Responsibilities : None

General Summary of Duties: Coordinates care with patients, referring providers and IMA Providers to schedule appropriate office appointments/ procedures. Obtains and directs patient EMR to IMA providers for approval. Advises patients of procedural and financial preoperative requirements at the clinic, ambulatory surgery center or hospital. This position is also responsible for making patient appointments, answering calls from a multi-line phone system, and following medical practice procedures.

Major Responsibilities/Tasks:

Patient Care Coordination:

1. Coordinate and schedule procedures, new patient, and follow-up appointments as designated by physicians according to established policies and procedures.

2. Interact with patients’, physicians and other staff within the clinic and at outside facilities providing

accurate, timely, and responsive information.

3. Review and accurately triage incoming referrals with precise documentation, within an appropriate response time. Obtain additional documentation as requested by IMA providers.

4. Collaborate with patients, referring providers/clinics to inform of IMA processes and expectations to obtain requested care.

5. Direct, and process referrals to appropriate IMA Physician/ Staff. Ensure that individual IMA Provider scheduling preferences are met.

6. Coordinate processes and timing as required to meet physician and facility and insurance requirements.

7. Coordinate arrangements for anesthesia, procedure prep, and outside facilities.

8. Schedule diagnostic therapy and other treatments as requested by the Physicians / Medical Providers at IMA.

9. Obtain authorization for procedures from patient’s insurance company.

10. Provide patient with accurate preoperative information and advise patients of preoperative procedure and financial requirements.

11. Submit patient clinical information to facility assuring appropriate medical records release, if needed.

12. Answer and screen telephone calls in a courteous manner, and record messages for physician and other personnel.

13. Obtain accurate information from patients and ensure all registration forms are complete.

14. Review demographic, financial and clinical paperwork to assure completion before the scheduled procedure or surgery date (This includes ABNs, if applicable).

15. Maintain files and patient records in a confidential manner in accordance to HIPAA and IMA policy.

16. Serve as a back-up for monitoring the Phone Que during high call volume times.

17. Perform other duties as assigned.

18. Distribute telephone inquiries generated to the appropriate department or person.

19. Receive and route messages and faxed, couriered, and other incoming documents in an accurate and timely manner.

20. Request office supplies as needed.

21. Maintain a clean and organized work space.

22. Maintain a neat and professional appearance as specified in the dress code policy.

23. Follows all Clinic policies on safety and security; maintains restricted areas safe by safeguarding keyless entry codes and computer system passwords in strict confidentiality.

24. Uses manual/computerized system to match physician/clinician availability with patient’s preferences in

terms of date and time.

25. Maintains scheduling system so records are accurate and complete and can be used to analyze patient/staffing patterns. Monitors daily schedules for physicians/clinicians or medical assistants prior to each day’s visits to ensure no discrepancies and minimal gaps in the clinic schedule.

26. Communicates as needed with physicians/clinicians and other staff about any patient concerns/issues related to front office or scheduling. Consults with supervisor about any system problems.

27. Uses customer service principles and techniques to deal with patients calmly and pleasantly.

28. All other duties as assigned.

EDUCATION: High school diploma or GED.

EXPERIENCE: A preferred minimum of two years of administrative assistant experience in a medical office, including experience with insurance preauthorization and patient collections.

Preferred Requirements: 

Knowledge:

· Knowledge of clinic policies and procedures.

· Knowledge of medical terminology and insurance practices.

· Knowledge of computer programs and applications.

· Knowledge of grammar, spelling, and punctuation to type, review and edit reports, documentation and correspondence.

· Knowledge of basic arithmetic to make calculations, balance and reconcile figures, and make changes accurately.

· Knowledge of CPT and ICD-10 coding. Skills:

· Skill in operating office equipment

· Skill in handling paperwork/filing adequately.

· Skill in handling incoming phone calls and triaging appropriately.

· Skill in written and verbal communication.

· Skill in gathering, interpreting, and reporting insurance information.

· Skill in trouble-shooting insurance issues and resolving appropriately.

Abilities:

· Ability to type 45 words per minute using word-processing software. Able to learn/use other computer programs including Microsoft® Excel, e-mail, Internet, and Microsoft® PowerPoint.

· Ability to operate multi-line phone system and route calls/tasks appropriately to needed departments.

· Ability to work effectively as a team member with physicians and other staff.

· Ability to be congenial, calm and effective under pressure.

· Ability to deal effectively with angry and upset patients.

· Ability to deal effectively with and resolve conflict situations.

· Ability to communicate and interact diplomatically and politely with patients, the public and co- workers.

· Ability to use the English language both orally and in writing.

· Ability to read and follow written instructions.

· Ability to sort and file materials correctly by alphabetic or numeric systems.

· Ability to interpret and understand insurance benefits and reimbursement.

· Ability to flexibly respond to changing demands.

· Ability to organize and prioritize tasks effectively.

· Ability to communicate clearly and professionally.

· Ability to work with little supervision.

· Ability to establish and maintain effective working relationships with patients, employees, and the public.

Equipment Operated: Office machinery including computers, fax, calculator, and photocopier. Occasionally lift and carry files up to 20 pounds.

Work Environment: Work performed in a medical office environment that is well lighted and well ventilated. Work may be stressful due to a busy office and the responsibilities of the position. This position involves continual interaction with IMA personnel, patients, vendors, financial institutions, pharmacies, other offices, and other servicers within the Anchorage, AK community both face-to-face, through means of written correspondence, and on the phone.

Mental/Physical Requirements: Manual dexterity for office machine operation including computer and calculator; stooping, bending to handle files and supplies, or sitting for extended periods of time. Stress can be triggered by multiple staff demands and deadlines. Must possess the physical and mental abilities to perform the tasks normally associated with the position such as some walking, bending, and reaching. Repetitive use of computer may lead to nerve damage without ergonomic measures. Stress from the responsibilities associated with this position.

Position Type/Expected Hours of Work:

The employee must be available during the work hours of 8:00 am and 5:00 pm, Monday through Friday, and is scheduled to work 40 hours each week to satisfy the needs of this position. This position has an estimated weekly requirement of overtime of approximately 0 hours weekly. Weekly hours requirements will remain flexible to accommodate the needs of IMA.

Employee Established Hours for this Position: TBD

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