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Patient Care Coordinator
Location
Rhode Island
Posted
8 days ago
Salary
$17 - $25 / hour
Seniority
Junior
Job Description
Patient Care Coordinator
CVS Health
• Support the Enteral Nutrition department by processing monthly patient refill requests • Ensure documentation is accurate before shipping orders • Answer incoming calls from patients, caregivers, branches and patient referral sources regarding nutrition therapy order status • Process prescription changes • Triaging calls to various departments • Verifying patient demographics and insurance information to ensure accurate shipment
Job Requirements
- Minimum one year experience in customer service in a healthcare environment
- Working knowledge of medical insurance and/or medical benefit programs and terminology
- Minimum one year experience working in Microsoft Office, specifically Excel, Outlook, and Word
- High School diploma or GED
Benefits
- Medical, dental, and vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families
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• Provide world class customer service and service delivery to clients and patients through processing referrals in the delivery of medical goods and services. • Reach out to patients in relation to new or already processing referrals confirming patient demographic information, providing updates on the referral, and/or confirming delivery of said goods or service. • Communicate with vendor partners, claims adjusters and nurse case managers providing updates on new referrals as well as referrals already in process. • Procure vendor partners for each referral as it relates to the goods or services requested. • Responsible for making or taking phone calls on existing referrals, new referrals, or other team members referrals. • Provide quotes back to clients for approval or follow up on quotes already sent to obtain written approval for requested referrals ensuring that each referral is deemed medically necessary and approved by the claim’s adjuster. • Confirm all required and relevant billing information exists in each referral as it relates to the workflow and billing processes in place and moves those referrals to be billed each day. • Process referrals per state regulations and workers compensation guidelines.
• provide an optimal customer service experience for patients, physicians, caregivers, and internal departments • answer questions, solve problems, provide education, and maintain company’s reputation for high-quality service • verify insurance coverage, perform benefit investigation, and obtain prior authorization • support the patient from the point of admissions/onboarding through the benefits verification and billing process
• Handle a high volume of inbound and outbound phone calls • Review lab results and communicate recommendations provided by Aftercare clinicians • Respond to patient clinical inquiries in accordance with established workflows and SOPs • Obtain and upload patient clinical documents into the medical record • Report applicable cases to the Department of Health (DOH) • Ensure all patient interactions are accurately documented and strive for one-call resolution • Respond promptly to tasks assigned through CRM (Salesforce) and EMR (Athena) systems • Effectively multitask across multiple systems to provide timely patient support and follow-up after clinical visits • Adhere to all HIPAA guidelines and organizational policies • Meet departmental goals and key performance indicators (KPIs)
• Complete individualized patient care plans and perform care management and care coordination services using Ennoble Care’s electronic medical record system • Frequent contact with patients to provide care coordination, support, and manage compliance with the care management programs to increase positive outcomes • Document all client communications (verbal or written) accurately • Communication to and from Primary Care Clinician or designee regarding patient emergent needs and/or life-threatening episodes and to ensure comprehensive care plans are complete and accurate • Keep Team Supervisor informed of all issues pertinent to the care plan process and any known or perceived issues • Demonstrate ability to work with various cross-organizational areas to meet the needs of Ennoble Care’s patients, their family members, and partner facilities • Become skilled at using technology including secure email, telephone system, electronic medical records, etc. • Adherence to documentation protocols and best practices for daily work logs, escalation of client issues, and internal communications • Excellent customer service skills demonstrated by positive feedback from customers and patients • Contribute as a positive member of the department by supporting all members of the team in a productive and constructive manner



