Patient Care Coordinator
About The Position
The Patient Care Coordinator works under the supervision of the Referral Management Center Supervisor and coordinates daily referral processes and related duties in the Radiology department. The role manages referral intake and reconciliation, administrative intake for members, records, and imaging exam requests and transfers. It also supports clinical staff with documentation and triage preparation, coordinates with hospitals, clinics, facilities, and clinical teams, and responds to member and provider inquiries. This is a high-volume customer service role requiring efficient, productive, and thorough phone interactions. The position is based at 1721 Rio Rancho Blvd SE in Rio Rancho, New Mexico, with training or coverage at other Albuquerque and/or Rio Rancho clinics as business needs require.
Requirements
- High school diploma or GED.
- At least 1 year of customer service experience in a healthcare setting.
- Intermediate proficiency with Microsoft Office applications, including Excel, Word, and Outlook.
- Ability to work a flexible schedule that includes evening hours.
Nice To Haves
- Experience working within the healthcare industry and with health insurance.
- Experience working in a hospital, physician's office, or medical clinic setting.
- Knowledge of ICD-9 and CPT codes.
- Previous experience working in radiology.
- Clerical or administrative support background.
- Previous experience working within an Electronic Health Record (EHR) system.
- Demonstrated ability to manage and respond effectively to high call volumes.
- Working knowledge of medical terminology and clinical documentation.
Responsibilities
- Manage internal and external referral processes and daily referral reconciliation, gathering required information and documents and processing them within established timelines.
- Manage administrative intake of members.
- Maintain department records as requested by the supervisor, department director, and/or regulatory agencies.
- Receive exam CD checkout requests and process them according to protocol.
- Receive and process outside-facility incoming exams in the RIS.
- Download outside-facility exams into PACS.
- Prepare and process outside-facility exams for return to the facility or patient.
- Process returned exams.
- Maintain CD files and purge outdated exams.
- Request pertinent prior exams for all modalities according to protocol.
- Work with hospitals, clinics, facilities, and the clinical team to manage service requests from members and/or providers.
- Process incoming and outgoing referrals and prior authorizations, including intake, notification, and census roles.
- Assist clinical staff with setting up documents and triaging cases for Clinical Coverage Review.
- Resolve inquiries from members and/or providers.
- Perform other related duties as assigned.
Benefits
- Paid Time Off accrued beginning with the first pay period, plus 8 paid holidays.
- Medical plan options and participation in a Health Spending Account or Health Savings Account.
- Dental, vision, life and AD&D insurance.
- Short-term and long-term disability coverage.
- 401(k) Savings Plan.
- Employee Stock Purchase Plan.
- Education reimbursement.
- Employee discounts.
- Employee Assistance Program.
- Employee Referral Bonus Program.
- Voluntary benefits, including pet insurance, legal insurance, and long-term care insurance.
- Incentive and recognition programs.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
