OVERVIEW:
The Patient Coordinator is responsible for verification of patient’s insurance, patient referrals from ODs and PCPs, Insurance Authorization for services; along with assisting the front desk check-in/check-out.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Assist with Table and Chair set up outside the breakroom as needed
- Assist with Logging in Retinal Drugs and stocking in appropriate refrigerator(s)
- Pull end of day Retinal Drugs and label boxes for next day prep for usage
- Request referrals for the following week (7 days from today’s date) for patients
- Verify new patient’s member eligibility and benefits; request referrals for those required by insurance plan
- Verify insurance for patients coming in the next day
- Inputs all referral requests including ICD-10 and CPT codes into NextGen system accurately for electronically generated authorization tracking
- Assist with requests submission of appropriate medical records according to established criteria for requested service(s)
- Issues authorization within the appropriate timeframe for routine, urgent and emergent requests
- Enter and scan all referrals including injections and lasers
- Learn how to fill out worker’s compensation claim paperwork and send to patient’s claim’s adjuster; FMLA; TEMPZA forms
- Assist with both offices Retina eligibility, referrals, and authorizations when needed and/or assigned
- Promptly and professionally answers telephone calls as needed
- Assist with mail or mail distribution when needed
- Learn how to assist with call confirmations when needed
- Other duties as assigned by the Front Office Supervisor, Practice Administrator or Physicians.
SUPERVISORY RESPONSIBILITIES:
- This job has no supervisory responsibilities.
COMPETENCIES – To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.
Intellectual
- Demonstrates attention to detail.
- Identifies and resolves problems in a timely manner.
- Uses reason even when dealing with emotional topics.
- Pursues training and development opportunities.
- Strives to continuously build knowledge and skills.
- Shares expertise with others.
Interpersonal
- Responds promptly to customer needs.
- Responds to requests for service and assistance.
- Focuses on solving conflict, not blaming.
- Maintains confidentiality.
- Listens to others without interrupting.
- Keeps emotions under control.
- Listens and gets clarification.
- Responds well to questions.
- Writes clearly and informatively.
- Edits work for spelling and grammar.
- Able to read and interpret written information.
Leadership
- Accepts feedback from others.
- Displays passion and optimism.
- Looks for ways to improve and promote quality.
- Demonstrates accuracy and thoroughness.
- Displays passion and optimism.
Organization
- Shows respect and sensitivity for cultural differences.
- Treats people with respect.
- Keeps commitments.
- Works with integrity and ethically.
- Upholds organizational values.
- Follows policies and procedures.
- Completes administrative tasks correctly and on time.
- Supports organization’s goals and values.
Self Management
- Adapts to changes in the work environment.
- Able to deal with frequent change, delays, or unexpected events.
- Is consistently at work and on time.
- Ensures work responsibilities are covered when absent.
- Follows instructions, responds to management direction.
- Takes responsibility for own actions.
- Asks for and offers help when needed.
- Uses time efficiently.
- Reacts well under pressure.
- Observes safety and security procedures.
- Determines appropriate action beyond guidelines.
- Reports potentially unsafe conditions.
- Uses equipment and materials properly.
Language, Math and Reasoning
- Ability to read and comprehend simple instructions, short correspondence and memos. Ability to write simple correspondence. Ability to effectively present information in on and one and small group situations to customers, clients and other employees of the organization.
- Ability to add and subtract two-digit numbers and to multiply and divide with 10’s and 100’s. Ability to perform these operations using units of American money and weight measurements, volume and distance.
- Ability to apply common sense understanding to carry out simple one or two step instructions. Ability to deal with standardized situations with only occasional or no variables.
EDUCATION, EXPERIENCE, and TRAINING:
- High school diploma or general education degree (GED); and one to three months related experience and/or training; or equivalent combination of education and experience.
- Knowledge of medical terminology and organization services.
- Knowledge multi-line phone systems which include ability to direct callers, transfer calls, and use paging system.
CERTIFICATES, LICENSES, REGISTRATIONS:
- There are no specific requirements for this position.
COMPUTER SKILLS:
- Excellent computer skills in a Microsoft Windows environment
- Word Processing Software including Microsoft Word
- Spreadsheet Software including Microsoft Excel
- NextGen – PM/EHR
- Internet Software
PHYSICAL DEMANDS – The 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.
- The employee must occasionally lift and /or move up to 10 pounds.
- While performing the duties of this job, the employee is regularly required to talk, hear, sit, use hands to finger, handle or feel.
- While performing the duties of this job, the employee is frequently required to stand and reach with hands and arms.
- While performing the duties of this job, the employee is occasionally required to climb or balance and taste or smell.
VISION REQUIREMENTS
The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading.
WORK ENVIRONMENT – The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.
- This position works in an environment with moderate noise level. (Examples: front office with computers and printers, heavy traffic.)
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Note: Nothing in this job specification restricts management’s right to assign or reassign duties and responsibilities to this job at any time. Critical features of this job are described under various headings above. They may be subject to change at any time due to reasonable accommodation or other reasons.
The above statements are strictly intended to describe the general nature and level of the work being performed. They are not intended to be construed as a complete list of all responsibilities, duties, and skills required of employees in this position.
