Patient Access Coordinator

Patient Access Coordinator

OC - Anaheim, CA 92801

Overview

Salary Range $22.00 - $26.00 Hourly Level Entry Position Type Full Time Job Shift Day Category Customer Service

Description

Who We Are

PACE by IIH is empowering senior participants to age at home with dignity through personalized, comprehensive care plans that deliver high-quality health and human services along with strong community support. Through an interdisciplinary and participant-centered model of care, PACE by IIH is committed to improving quality of life, promoting independence, and providing compassionate support tailored to the unique needs of each participant. Our team works collaboratively to deliver innovative, community-based healthcare solutions that allow seniors to remain safely and comfortably in their homes while receiving the care and services they need to thrive.

Benefits

• 401(k)
• Dental insurance
• Employee assistance program
• Employee discount
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid sick time
• Paid time off
• Referral program
• Retirement plan
• Vision insurance

Job Summary Under the supervision of the Operations Manager, the Patient Access Coordinator is responsible for various aspects of the department including but not limited to order entry, the authorization process, scheduling, and confirmation calls. Responsibilities include collecting all necessary documentation, contacting the referring provider office for additional information and completion of the required prior authorization form in order to proceed with the request. The Patient Access Coordinator will serve as a liaison between patients and medical staff. Must display excellent communication, organization, and follow-up skills with the ability to handle multiple assignments simultaneously. In addition, demonstrates good judgement as well as attention to detail.

Essential Job Functions Duties include, but are not limited to:

• Works towards the organization's goal of providing timely outside provider access for our participants.
• Ensure timely and effective scheduling of new patient consults and/or continuous outside care in accordance with physician and/or office guidelines.
• Obtain prior authorization information in accordance with established guidelines.
• Verify prior authorizations and/or pre-service requirements are met.
• Order Entry of Prior Authorization Requests received.
• Timely completion for all prior and retroactive authorization requests.
• Documenting authorization status and demonstrating proficiencies with Electronic Health Records systems.
• Appropriately schedule all specialty appointments
• Coordinate transportation and interpretation services for all specialty appointments as needed.
• Confirm new patients and return appointments in computer system in accordance with physician and/or office guideline.
• Make confirmation calls to both outside providers and participants per office guidelines.
• Provide outstanding customer service to participants and develop and maintain positive working relationships with internal and other external customers.
• Uses customer service principles and techniques to deal with patients, physicians and medical office staff calmly and pleasantly.
• Meet or exceed all daily, weekly and monthly production goals.
• Document all activity and correspond to inquiries in a timely manner.
• Identifies prior authorization trends and/or issues resulting in delayed processing.
• Identifies scheduling trends and/or issues resulting in delays.
• Communicates and works effectively with colleagues from other departments.
• Follows written and verbal communications.
• Follows all Innovative Integrated Health (IIH) health and safety policies and procedures.
• Follows policies and procedures to contribute to the efficiency of the department.
• Performs other administrative tasks and/or projects required to meet performance and customer services standards.
• Performs other related duties as required or assigned.

Qualifications

Knowledge, Skills, and Abilities Computer Skills

• Computer skills including typing and knowledge of applications such as Microsoft Office Suite (Outlook, Word, Excel, PowerPoint, etc.) and Windows is required.

Language Skills

• Ability to effectively present information and respond to questions from management, participants, auditors and coworkers.

Essential Functions

• Track and schedule patient referrals
• Process authorizations
• Order entry for Prior Authorization requests
• Confirmation calls of appointments to both outside providers and participants

Abilities

• Ability to read, understand and follow oral and written instructions.
• Ability to use multi-line phone system, including transferring calls.
• Ability to provide consistent follow-through to guarantee completion of all assigned duties.
• Ability to establish and maintain effective working relationships with patients, physicians, other clinical staff and the public.

Working Conditions and Physical Demands The working conditions and physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Ability to access all areas of the center throughout the workday. Ability to lift up to 35 pounds occasionally, 15 pounds frequently, and 7 pounds constantly; required to obtain assistance of another qualified employee when attempting to lift or transfer objects over 25 pounds.

Experience

• Two (2) years of experience in a scheduling, authorization and referrals health care setting preferred
• Managed care experience preferred.
• Strong Customer Service background.
• Knowledge of medical terminology.
• Skilled in organizational techniques including time management, prioritization, multitasking, and problem solving.
• One (1) year of documented experience working with a frail or elderly population preferred.
• EHR experience a plus
• Health insurance experience and knowledge preferred.

Education and Certification

• Associates degree in health care preferred.

Core Values

• CARE is central to what we do, prioritizing the well-being, dignity, and independence of our senior participants.
• COMPASSION in every interaction, ensuring kindness, empathy, and understanding guide our care.
• CULTURE that reflects the diverse backgrounds of those we serve and fosters a workplace where every team member feels supported, valued, and empowered to grow.
• COMMUNITY that fosters connection, belonging, and support for participants and their families.
• COMMITMENT to quality improvement, innovation, and delivering healthier outcomes.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.