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Company: MedStar Medical Group

Location: MD

Career Level: Entry Level

Industries: Not specified

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Description

General Summary of Position
Performs the primary function of completing/processing patient referrals to include data entry functions, contacting patients to confirm accuracy of information, and communications with other departments as needed to ensure complete and accurate information.

Primary Duties and Responsibilities

Contributes to the achievement of established goals and objectives and adheres to department policies, procedures, quality standards, and safety standards. Completes annual Code of Conduct, Compliance and other mandatory training. Complies with governmental and accreditation regulations.

Customer Service: Represents MedStar Health Home Care in a positive and professional manner through attitude, customer service and response to inquiries and problems. Maintains effective working relationships with internal referral sources and patients and their families by exhibiting a courteous and helpful manner in communication. Answers phone calls promptly and provides requested and accurate information and returns phone calls within appropriate time frames as determined by department.

Referral Development: Supports community account managers and hospital based clinical consultants in the coordination and/or outsourcing of home care referrals. Receives and enters appropriate patient demographic, clinical and insurance information from referral sources, verifying insurance or obtaining authorization by communicating with reimbursement coordinators and obtaining staffing availability by communicating with appropriate clinical team when required as soon as referral received.

Referral Processing: Enter all required patient demographics, payor and clinical information fields in the home care database in order to assure complete and accurate home care referrals. Verifies and documents Medicare Eligibility for homecare and creates billing sequence. Communicates with internal referral sources and patients and their families. Provides feedback to clinical consultants and account managers when insurance verification indicates a potential problem.

Supports clinical operations as needed through additional workflow completion, coordination with schedulers and other operational support team members, and contributes to the successful completion of the patient billing cycle by ensuring all necessary forms are present and complete (e.g. Face-to-face, insurance authorization.)

Teamwork and Professional Development: Maintains effective working relationships with other departments and participates in multi-disciplinary quality and service improvement teams. Participates in meetings and on committees and represents the department and agency in community outreach efforts. Enhances growth and development and enriches personal knowledge and skill through participation in educational programs and affiliations.

Technology: Maintains working knowledge of and uses various technology and applications to complete the home care referral process such as HomeCare HomeBase. Monitors fax machine and other electronic systems such as Forcura and responds within appropriate time frames and prior to departure.

Insurance Verification: Obtains verification of the patient's insurance, including use of available on-line insurance information as well as outreach to the patient and patient family as needed. Responsible for the timely input of complete and accurate insurance information in payor fields in Home Care Home Base (HCHB). Communicates with business development staff when insurance verification indicates an alert preventing the successful processing of the patient's insurance.

Maintains working knowledge of all contracted third-party payer requirements and the impact on verifying patient insurance, seeking authorizations, and acceptability of the payer for successful billing.

Monitors workflow and databases for outstanding referrals, verifications, authorization or re-authorizations to ensure timely processing of patients for services and care, and billing.

Participates in meetings and on committees and represents the department and hospital in community outreach efforts.

Participates in multi-disciplinary quality and service improvement teams.

CUSTOM.PRIMARY.DUTIES.RESPONSIBILITIES.ADDENDUM

Minimum Qualifications
Education

High School Diploma or GED required and
Knowledge of medical terminology required

Experience

Clerical/office experience, preferably in a healthcare setting required
Insurance verification experience and/or medical claims experience preferred

Knowledge, Skills, and Abilities

Working knowledge of various computer software applications.
Proficiency in Microsoft Word, Excel, Outlook and Internet Explorer.
Effective problem-solving skills and ability to work independently.
Team player, strong interpersonal skills, including verbal and written communication.
Ability to communication with patients, their relatives, physicians and a variety of personnel.
Verbal and communication skills.

This position has a hiring range of $20.17 - $35.04

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Customer Care Coordinator Job Listing at MedStar Medical Group in MD (Job ID req49589)

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Customer Care Coordinator Job Listing at MedStar Medical Group in MD (Job ID req49589)

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