Patient Coordinator

Job Responsibilities:

• Sends Admit Form to Admitting Department for patient registration within Care Health System (CCHS); reviews authorization requirements from Admitting Department; coordinates with Admitting Department any required letters of non-coverage as required.
• Sends Evicore Healthcare Form (if appropriate) to ordering Radiation Oncologist or his designee on the day of CT; uses information from Evicore form to request authorization; collaborates with Billing Representative for correct CPT codes for all other insurances; responds to Quality Check Lists (QCL) in a timely manner to avoid delays in the start of patient treatments.
• Obtains authorization from insurance companies prior to (if orders are in) or at the time of CT; once approved, enters approved authorization number, case number, expiration date, and number of approved visits in patient’s EMR under Insurance tab and in Soarian; communicates via email with Radiation Oncologist and Dosimetry when insurance denies coverage; schedules Peer to Peer upon request. Collaborate with Finance if an appeal process is indicated.
• Schedules patients for imaging services documenting scheduled date in patient’s EMR; informs patient of scheduled exam date, time, and location.
• Responds in a timely manner to the Hospital Billing Representative regarding claim denials and status on payment; notifies Oncology Social work of any patients who are self-pay/no insurance so patients can receive estimates of the charges for radiation oncology technical services; notifies Radiation Oncologists of patients who are self-pay so professional charges can be estimated.
• Participates in the Monday – Friday Dosimetry huddles on a rotating basis; shares information from huddle with other Access Coordinators; works collaboratively with other Access Coordinators regarding assignment of authorizations that are high priorities based on information from Dosimetry huddle; makes workflow adjustments to accommodate patient volume surges.
• Maintains a solid working knowledge base of insurance requirements specific to radiation oncology; creates a collaborative working relationship with insurance representatives.
• Performs assigned work safely, adhering to established departmental safety rules and practices; reports to supervisor, in a timely manner, any unsafe activities, conditions, hazards, or safety violations that may cause injury to oneself, other employees, patients and visitors.

Skills:

• Knowledge of appropriate departmental and hospital standards, policies, and procedures Knowledge of Current Procedural Terminology (CPT) codes Ability to operate office equipment in a safe manner Ability to effectively communicate for all levels of customers served Ability to function as a member of a multidisciplinary team Ability to learn and understand basic medical terminology Ability to organize and prioritize work assignments Ability to multi-task Ability to navigate in both electronic medical record systems, Mosaiq and ARIA

Education/Experience:

• Associate degree in Business/Medical related field preferred 2 years’ experience in a medical, or financial institution preferred an equivalent combination of education and experience may be substituted