Patient Care Coordinator II

Tulane University • Metairie, LA

6h • Onsite

About The Position

The Patient Care Coordinator II is a full-time position within Tulane University Medical Group. This Coordinator is responsible for scheduling ambulatory and inpatient care with the hospital, ambulatory facilities, and post-acute care facilities when a clinical service is determined to be needed by a patient. Verifies patient’s insurance and benefits paid by third parties. The coordinator obtains authorizations required from private, commercial, and government carriers for patient treatment, and commercial works with patients’ insurance companies to meet their specific information requirements for specific services.

The Coordinator works directly with the patient and facility, answering insurance questions as appropriate and confirming the service schedule. This position is not responsible for providing care to patients.
This position works closely not only with the payors and patients to get authorization for payment for services, but with all care providers of the Tulane University Medical Group: physicians, advance practice professionals, case managers, case workers, nurses, facility staff/schedulers, financial advocates, to determine if care is to be funded by the patients’ health insurance or some other method. Works to resolve issues that arise during the authorization process and during follow-up. The position requires a significant amount of independent and unsupervised work. Position requires critical thinking skills and autonomy to resolve payment concerns of the complicated care of patients and providers, including addressing the requirements of payors for information and documentation of medical necessity and clinical need for services to be rendered. Position is critical to physician billing and claims going out “clean” for quick review and payment.

Requirements

• Significant amount of independent and unsupervised work.
• Critical thinking skills.
• Autonomy to resolve payment concerns.

Responsibilities

• Scheduling ambulatory and inpatient care with the hospital, ambulatory facilities, and post-acute care facilities.
• Verifying patient’s insurance and benefits paid by third parties.
• Obtaining authorizations required from private, commercial, and government carriers for patient treatment.
• Working with patients’ insurance companies to meet their specific information requirements for specific services.
• Working directly with the patient and facility, answering insurance questions and confirming the service schedule.
• Working with care providers to determine if care is to be funded by the patients’ health insurance or some other method.
• Resolving issues that arise during the authorization process and during follow-up.
• Resolving payment concerns of the complicated care of patients and providers.
• Addressing the requirements of payors for information and documentation of medical necessity and clinical need for services to be rendered.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed