Patient Care Coordinator - Weight Management

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At Houston Methodist, the Patient Care Coordinator position is responsible for serving as an initial point of contact for patients, employees, clients, medical staff and other callers seeking help from the department. The Patient Care Coordinator performs duties including but not limited to coordinating needed physician referrals and appointments, obtaining and recording eligibility and benefit information for patients receiving services and initiating authorization process in a timely manner.

This position has the ability to perform more complex processes related to insurance verification, authorization, and financial clearance. The Patient Care Coordinator will also utilize effective communication skills in all interactions with patients, coworkers, insurance companies, physicians etc. This position coordinates, records and transmits information pertinent to the resource management of patients to next level of care providers and performs a wide variety of administrative duties of a higher complexity in support of department operations.

Non-exempt

• High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.)

• Three years of insurance verification experience in a healthcare setting, preferably in a hospital or clinic setting

Required

• Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through ongoing skills, competency assessments, and performance evaluations
• Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security
• Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles
• Ability to manage a fast-paced environment, to review clinical documentation for Medical Necessity and payer requirements, and have a high level and knowledge of medical terminology, CPT, ICD-10; knowledge of Medicare, Medicaid, and managed care reimbursement methodologies
• Ability to work under pressure and balance many competing priorities
• Adapts to multiple ongoing priorities with minimal supervision, including organizing workflow and actively participating in problem-solving

• Answers incoming telephone calls, troubleshoots and directs calls and requests to appropriate individuals from patients, employees and clients while evaluating, documenting and managing their needs. Proactively acts as a patient advocate, responding to and working to resolve patient concerns.
• Supports patients, coworkers, insurance companies, physicians, etc., with questions regarding pending authorizations and eligibility/benefit information for patients receiving services. Assists other team members (e.g., Patient Service Coordinator, account integrity) as directed by management. Seeks management assistance appropriately.
• Contributes to patient, employee, and physician satisfaction. Proactively presents solutions to resolve access to care issues when possible. Serves as a liaison between the patients, facility, physicians, and department to ensure timely and accurate financial clearance of all accounts. Communicates with scheduling to inform patient of authorization as needed.
• Assists and coordinates various functionality and utilization of patient and client database including data entry; assuring database is kept up-to-date. Proactively contacts patients and clients to arrange follow-up on process or outcome goals that are determined or required.

• Coordinates and arranges appointments for providers and patients for patient meetings, procedures, and appointments and sends correspondence as designated. Assists with clerical functions for patients and clients, coordinating referrals and services, following department…