Health Services Coordination Specialist

Central Health•Austin, TX

About The Position

The Health Services Coordination Specialist reports to the Navigation Center Healthcare Services Supervisor at the Central Health Navigation Center. The role provides primary referral management support through the Navigation Center call center for services performed by Central Health Network providers and may also support incoming referrals for Central Health services. Duties include referral processing, patient registration, benefit verification, insurance authorization, appointment scheduling, educating patients about referral processes, verifying medical information, and communicating with referral sources. At least 50% of working hours are spent onsite in the Navigation Center. Approximately 80% of staff time is dedicated to incoming and outbound calls related to specialty-service referrals and appointments with contracted network partners. Approximately 20% is devoted to off-phone activities, including document and fax organization, patient correspondence, and data entry for preregistration. The specialist also manages referral workflows, coordinates transportation for eligible patients, processes authorization requirements, and helps ensure patients’ access to contracted services while protecting confidential health information.

Requirements

High school diploma or equivalent.
At least 3 years of previous direct healthcare, medical office, and/or healthcare call center experience.
At least 1 year of previous scheduling, registration, referrals, and/or billing experience.
Strong relationship-building and customer-service skills.
Strong attention to detail and accuracy.
Ability to use computers for data entry and information retrieval.
Excellent verbal and written communication skills.
Knowledge of federal, state, and local insurance regulations.
Knowledge of referral processes for a variety of insurance plans.
Ability to research and resolve complex issues.
Familiarity with electronic devices and common healthcare-environment GUIs, including personal computers, spreadsheets, word processing, patient record systems, and EHR systems.
Knowledge of healthcare-system navigation for coordinating specialty services, laboratory services, imaging, and diagnostic services.
Ability to problem-solve and make decisions to support streamlined operations.

Nice To Haves

Bilingual Spanish/English.
Successful completion of a Medical Assistant Certification program; Certified Medical Assistant (CMA)-AAMA preferred.

Responsibilities

Handle incoming calls and make outbound calls to initiate contact after receiving specialty-services referrals for contracted network partners.
Schedule appointments on behalf of patients and confirm adherence to appointments with contracted network services.
Perform off-phone administrative work, including scanning and organizing electronic documents, organizing electronic fax records, preparing patient mail correspondence, and supporting preregistration data entry.
Resolve patient inquiries, including MyChart support, member benefits, basic clinic information, payment processing, patient financial responsibility, and initiating the MAP/MAP Basic Member or Central Health patient complaint or compliment process through the incident management system.
Use multiple healthcare software platforms or EHRs to schedule specialty appointments, imaging, or diagnostics at contracted network facilities outside Central Health.
Request or receive patient records and communicate with contracted network partner staff to support a seamless patient experience.
Book transportation for patients who qualify for appointments with Central Health contracted network partners.
Provide customer service while scheduling and confirming appointments using multiline phones and entering data into the EHR, maintaining strict confidentiality of personal health information.
Manage assigned referral work queues for incoming and outgoing network specialty-services consults and manage inbound electronic fax lines for referrals and relevant health information.
Send outbound faxes to contracted network partners and process time-sensitive inbound or outbound documents related to partner services.
Complete third-party payer preauthorization processes and requirements for imaging and diagnostic orders placed by Central Health providers.
Secure, document, and transmit information related to third-party authorizations for outbound referrals or diagnostic and imaging orders.
Develop and maintain positive working relationships with coworkers, clinical managers, clinical support staff, providers, and business office staff.
Ensure patient-care tasks, administrative processes, and related duties comply with regulatory and accreditation standards and Central Health policies and procedures.
Attend required staff meetings and educational offerings in person or online, and support organizational initiatives that promote a positive workplace culture.
Meet or exceed assigned productivity metrics.
Perform other duties as assigned.