• Job Description

  Req#: 14109

  Job Description:Collaborates with other referral staff, medical providers, and patient care support staff to effectively communicate and ensure successful tracking and coordination of care. Creates a proactive care plan based on patient’s needs and goals.Monitors and follows patient’s care plan to assist in coordination of services and scheduling of appointments. Alerts PCP,staff, and management of any identified potential issues. Responsible for following care once patient has been discharged from hospital to home. (i.e., appointments with PCP within one week from discharge, verifying if patient requires home health or equipment to make sure they are in safe environment). Enters referrals within allotted timeframes based on type of request, and meeting performance measurement standards for accuracy of referrals. Demonstrates the ability to explain managed care principles to others, i.e., contracted, non-contracted, in-network, out-of-network, etc. Verifies patient's eligibility coverage and resolves discrepancies of eligibility. Educates and interprets benefit inquiry presented by staff, physician, facilities, or vendors. Patient Access Care - Provides efficient, accurate, and effective customer focused communication services to enhance our patients’ experience. Answers telephone calls in a timely manner and when appropriate, screens and transfers calls, takes written messages and routes the message to appropriate location or individual. Properly documents the disposition and outcomes of all calls, following stated protocols. May complete outgoing calls or send written communications to patients. May perform other duties as assigned.

  
  Minimum Job Qualifications: High School Diploma or equivalent. At least (3) years experience working in a hospital or healthcare setting in a position requiring interaction with patients and/or providers relating to Care Coordination. Experience with prior authorizations, referrals, electronic health records documentation, and have the experience interacting with providers, patients and caregivers to coordinate care and develop relationships. Intermediate level of computer proficiency (multitask through multiple applications including Teams, Microsoft Outlook, Word, and Excel). Ability to maintain composure during challenging interpersonal interactions. Active listening skills; including interpersonal skills and telephone communication. Excellent organizational skills with attention to detail and follow-up. Critical thinking and problem-solving skills to identify and resolve problems in a timely manner. Knowledge of Medical Terminology, CPT codes, and ICD 10 for Managed Care or Physician’s Office.Fluent in the English language

  Preferred Qualifications: Some college courses completed in business communication. Medical Assistant preferred. Some Spanish preferred.

  Salary Range: $24.68-$34.73 hourly. Salary will be commensurate with experience.

• About the company

  Since 1903, Pomona Valley Hospital Medical Center has been providing excellent medical services to the local community. Nationally recognized for quality care!

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