Managed Care Coordinator - SouthPark Endocrinology

Managed Care Coordinator - SouthPark Endocrinology

General Job Summary:

The duties and responsibilities of this position include assisting patients and providers with coordinating of referrals, obtaining authorizations and scheduling.  This position is also responsible for understanding benefits coverage and ensures the patient’s care is coordinated.

Primary Job Responsibilities/Tasks may include, but not limited to:

Responsibilities:

• Completes referrals for patients and coordinates with referring and receiving practices and/or departments.
• Obtains prior authorizations for medications needed.
• Reviews benefits and educates patient on insurance coverage.
• Diagnostic testing (Home sleep studies).
• Reviews schedules and confirms schedules are accurate and time is properly allocated.
• Follows up on all referrals to ensure no care gaps.
• Handle sensitive information in a confidential manner.
• Other duties as assigned.

Requirements:

Education, Experience and Certifications:

• High School Diploma or GED required.
• Thorough understanding of insurance coverage and Medical Necessity policies preferred. 
• Customer service experience required.
• Knowledge of medical records software preferred.
• Completion of Hepatitis B Vaccine and Flu Vaccine Form will be required.  Candidate may decline vaccination through declination form or may provide record of vaccination from previous employer.
• Completion of TB test will be required.

Physical Requirements:

• Work consistently requires walking, standing, sitting, lifting, reaching, stooping, bending,pushing, and pulling.
• Must be able to lift and support weight of 35 pounds
• Ability to concentrate on details.
• Use of computer for long periods of time.