Coordinator II - Customer Navigation

HonorHealth•Phoenix, AZ

1d•Onsite

About The Position

The primary contact for patients who contact the Customer Navigation Center regarding ambulatory specialty provider referrals. The primary role is to obtain referral authorizations, optimize care coordination, customer navigation, specialty appointment scheduling and support in-network referrals processing, Drive business to high quality, aligned specialists across our network. At HonorHealth, you’ll find something special. Our culture is built on warmth and neighborly kindness, but behind every smile is a highly skilled professional with deep expertise and unwavering dedication. We’re delivering a healthcare experience that simply feels better through: • Nine acute-care hospitals • Over 200 primary, specialty and urgent care centers • More than 17,000 team members and 4,000 medical staff Since 1927, we’ve been focused on doing what matters most — caring for people and communities across the greater Phoenix area. From humble beginnings to one of Arizona’s largest nonprofit healthcare systems, we’re just as driven as we were a century ago. Come join us and go all in for your career.

Requirements

High School Diploma or GED - Required
2 years of call center experience - Required
Typing a minimum of 45 words per minute (WPM) - Required
Basic knowledge of insurance plans and requirements
Knowledge of physician specialties and hospital services offered
Knowledge of medical terminology - Required
Successful completion of competency module (Level 2) upon hire - Required

Nice To Haves

Associate's Degree or medical assistant certification - Preferred
Bilingual in Spanish (conversation) - Preferred

Responsibilities

Demonstrates high level knowledge of insurance requirements for referral authorization and care coordination
Consistent coverage verification for patient appointments, including specialty referrals to HonorHealth Medical Group, PSAs, ACOs and aligned specialists in our network.
Gather appropriate clinical documentation to support the referral authorization and subsequent specialty appointment scheduling.
Keep current on all knowledge base articles and workflow changes posted in Teams Channels
Document both ordering and receiving provider by name and location within Referral Management System and EPIC so patient journey can be properly monitored, data reporting can we accurate and any gaps identified early.
Understand and utilize provider scoring for quality, access to care, location, insurance compatibility when sending referrals to specialists.
Make the “best fit” recommendation when not otherwise indicated by ordering provider.
Escalate any issues with provider data in Referral Management System or EPIC platforms so provider data can be quickly updated.
Escalate any care availability or customer service issues with provider offices to Supervisor for follow up.
Utilize internal and external resources to seek knowledge about insurance plans.
Send proactive messages to both patient and ordering/ receiving providers about referral processing statuses.
Meet productivity metrics and quality KPIs on a daily/ weekly basis.
Performs other duties as assigned.