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 delivered by Central Health Network providers, and may also support incoming referrals for Central Health services. The position performs administrative and patient coordination tasks including referral processing, patient registration, benefits verification, insurance authorizations, appointment scheduling, referral process education, medical information verification, and communication with referral sources. At least 50% of working hours are spent onsite in the Navigation Center. Approximately 80% of staff time is spent handling incoming or outgoing calls, while approximately 20% is devoted to off-phone administrative activities.

Requirements

High school diploma or equivalent.
At least 3 years of direct healthcare, medical office, and/or healthcare call center experience.
At least 1 year of 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 GUIs, including personal computers, spreadsheets, word processing, patient record systems, and EHR systems.
Knowledge of healthcare-system navigation for coordinating specialty services, labs, imaging, and diagnostic services.
Ability to problem-solve and make decisions to streamline operational processes.

Nice To Haves

Bilingual in Spanish and English.
Successful completion of a Medical Assistant certification program; Certified Medical Assistant (CMA) credential from AAMA preferred.

Responsibilities

Handle incoming calls and make outbound calls to initiate contact after specialty-service referrals to contracted network partners, including booking appointments and confirming appointment adherence.
Perform off-phone administrative tasks such as scanning and organizing electronic documents, organizing electronic fax records, preparing patient mail correspondence, and supporting pre-registration data entry.
Resolve patient inquiries, including MyChart support, member benefits, basic clinic information, payment processing, patient financial responsibility, and initiating complaints or compliments through the incident management system.
Use healthcare software platforms and EHRs to schedule specialty appointments, imaging, and diagnostics at contracted network facilities; request or receive patient records; and communicate with network partner staff.
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, while protecting confidential health information.
Manage assigned referral work queues for incoming and outgoing network specialty-service consultations and manage inbound electronic fax lines for referrals and relevant health information.
Send outbound faxes to contracted network partners and process time-sensitive documents related to partner-provided services.
Complete third-party payer preauthorization requirements for imaging and diagnostic orders, and secure, document, and transmit authorization information for referrals and diagnostic or imaging orders.
Develop and maintain positive working relationships with coworkers, clinical managers, clinical support staff, providers, and business office staff.
Ensure work related to patient care and administrative processes complies 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.