"Alerted.org

Employment Type:

Full time

Shift:

Day Shift

Description:

POSITION PURPOSE-

Care specialists coordinate with regional call center specialists, nurse navigators, physicians and other health care professionals to provide critical support functions to assure a remarkable and efficient experience in the Care Coordinating Center (CCC) which serves as the single point of entry for all new patients of the west market cancer programs (including high risk breast, lung nodule, lung cancer screening, Genetic Counselor programs and other support services). Care Specialists, provide non-licensed support to Nurse Navigators and act as a team to triage patient-specific information to coordinating care and accurately determine the nature of appointments necessary. Will independently schedule, obtain necessary insurance verification and authorizations and confirm patient appointments, including clear instructions to patients for a wide variety of services including, but not limited to Radiology, IHA specialists, Radiation Oncology, Cancer Care Specialty Center, Gynecologic Oncology . Serves as lead to triage all phone calls coming into the Care Coordinating Center. Also acts as a resource to any patient/family/physician calling for assistance

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

+ Provide optimal level of customer services and maintain professionalism to resolve all customer issues and provide all information on patient services available in the cancer program

+ Provide exceptional customer services at all times and maintain courtesy and professional at all times and assisting with a wide variety of situations and special request of patients and referring physicians

+ Serving as a direct contact and resource to the patients/family's providing emotional support and education.

+ Prepare patients for appointments, providing information in a clear understandable manner and providing written follow-up in the manner patient prefers (texting, email, mail)

+ Manages flow of patient new patient materials

+ Demonstrate excellent critical thinking skills as they interview patients and gathers information to assure accurate and timely assessment and intake into program, entering information into all computer systems necessary (NEXGEN, ARIA, Healthquest, Powerchart)

+ Collects complete and accurate financial and insurance information to performs accurate registration and insurance verification , obtaining required authorizations as indicated.

+ Utilizes multiple system applications simultaneously to complete the scheduling, order management, pre-registration and insurance verification processes including but not limited to ARIA, Healthquest, NEXGEN, Patient Management and Patient Accounting, Powerchart, Freedom Imaging, Pathways Compliance Advisor, Emdeon Real Time Eligibility, Avaya, WebDennis, Medfusion, CMS, and Intuit web portal. Completes these actions on behalf of IHA and the hospital.

+ Provides information to patients concerning hospital and IHA policies and regulatory requirements utilizing effective interpersonal and guest-relations skills

+ Reviews, analyzes and corrects report entries to ensure accurate scheduling and registration, and makes assures financial clearance is obtained prior to services being rendered.

+ Verifies insurance coverage using Real Time Eligibility system tool for all scheduled services to facilitate accurate assignment of financial responsibility and claims submission.

+ Responds to problems and questions from Clinical Departments or PFS Teams.

+ Demonstrates understanding of prevailing regulatory and 3rd party requirements (MSP, authorization requirements, medical necessity screening, etc.).Determines need for authorization for treatment/procedures and coordination of benefits as required.

+ Identifies opportunities to improve the quality of coordination of care , scheduling, registration and/or verification processes.

+ Demonstrates accountability to follow-up with patients concerning requests for information of action regarding their appointment and/or care coordination.

+ Demonstrates team-player abilities and seamless service to patients

+ Maintains good rapport and cooperative relationships. Approaches conflict in a constructive manner. Helps to identify problems, offer solutions, and participate in their resolution.

+ Enters accurate data into disease specific quickbase programs for quality analysis

+ Maintains the confidentiality of information acquired pertaining to patient, physicians, associates, and visitors to St. Joseph Mercy Health System. Discusses patient and hospital information only among appropriate personnel in appropriately private places.

+ Behaves in accordance with the Mission, Vision and Values of SJMHS.

+ Assumes responsibility for performance of job duties in the safest possible manner, to assure personal safety and that of coworkers, and to report all preventable hazards and unsafe practices immediately to management.

OTHER FUNCTIONS AND RESPONSIBILITIES

_Performs other duties as assigned._

REQUIRED EDUCATION, EXPERIENCE AND CERTIFICATION/LICENSURE

Education: High school diploma or equivalent required. Associates degree or some college courses preferred.

Experience: 3-5 years of experience in a medical or physician office or comparable healthcare environment required.

Our Commitment to Diversity and Inclusion

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.

Our Commitment to Diversity and Inclusion

Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.

EOE including disability/veteran