Care Coordinator I Bilingual

Job Description

Job Description

Description : JOB SUMMARY :

The Care Coordinator I is responsible for providing care coordination services for clients in their

assigned group. The Care Coordinator I will assess clients with all care management needs and

address any potential barriers to care, to ensure timely diagnosis and treatment. Under direction of

the supervisor, the Care Coordinator I will maintain a clinical tracking system to ensure

appropriate follow-up, reporting and billing.

DUTIES AND RESPONSIBILITIES

Demonstrate proficiency and efficiency in processing referrals (specialty care and ancillary services), verifying insurances, and acquiring authorization for services if needed.

• Demonstrate proficiency in following up on referrals submitted and retrieving progress notes from specialist in order to close out referral loop and assisting with obtaining second referral if necessary.
• Demonstrate proficiency in documenting activities performed on clients in EHR and C3 database, as well as in looking up patient accounts and encounters in the EHR, EPM, and C3 database, using a variety of fields including but not limited to name, birth date, social security number, and account number.
• Documents and updates PHI log in EHR when referrals are sent / processed.
• Assist in updating to maintain patient demographics in EPM, EHR and C3 database.
• Assists providers with follow-up on referral as well as no-shows as directed by providers or contract staff. Assists with obtaining second referral if necessary
• Actively responds to phone calls from contractors and / or patients who may be in need of referrals or medical records for patient’s continuum of care.
• Demonstrate a strong ability to scheduling, rescheduling, and cancelling patient appointments according to established protocols by service line (medical, obstetrics, dental, and behavioral health) and by provider.

Maintains faxes received in-patient EHR and acquires provider’s signatures for faxes needing provider approval for services provided.

Flags charts for alerting staff regarding non-compliance services or needing updates to demographics.

Assist clinical teams in patient assessment via receipt of reports or review of charts that show abnormal labs / findings and notify clinicians in the event of an emergency.

Demonstrate proficiency in using great customer services skills / proper phone etiquette when communicating with patients by phone, text messaging system, or by patient portal

Understands and upholds CentroMed’s mission and values relating to ethics, integrity, safety, corporate responsibility and objectives

Actively participates in maintaining high levels of excellent customer service internally and externally

Ensure the protection and security of all personal, confidential and identifiable information in a professional and responsible manner and carry out all measures to prevent unauthorized disclosures. Demonstrating and maintaining the standards and requirements of the Health Insurance Portability and Accountability Act (HIPAA).

Assists in training new employees in performing their job duties as requested.

Performs all duties in conformance to appropriate safety and security standards.

Performs other duties assigned.

Requirements : QUALIFICATIONS :

Education : High School diploma or equivalent

Medical Assistant certification preferred

Experience : Six months experience in a public health care setting preferred.