Outpatient Coordinator - Northridge, United States - REGAL MEDICAL GROUP, INC

REGAL MEDICAL GROUP, INC

Verified Company

Northridge, United States

3 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

Position Summary:

The role of the Outpatient Coordinator is to promptly, efficiently and accurately execute all aspects of the referral process. Promote the quality and cost effectiveness of medical care through strict adherence to all UM Policy and procedure.

Essential Duties and Responsibilities include the following:

Anticipate our customer needs: Understand the wants and needs of customers, listen for cues and identify how to respond and what level of intervention they need2. Understand and execute the principles of UM to facilitate the right care at the right time in the right setting.
Communicate effectively and interact with the provider group and health plans daily or as indicated regarding UM and referral authorization issues.
Data entry via GCEA/REA
Process request that are approved, denied or deferred and bring them to resolution.
Responsible for Deferred authorization maintenance, tracking and follow up.
Responsible for the EIOD process, including log maintenance; and patient notifications
Checks eligibility and benefits on all DME and home health authorizations prior to forwarding on request to prior authorization nurse or medical director for approval.
Returns phone calls to customers and follows up with requests.
Maintain turnaround time compliance in all aspects of the UM process.
Maintain all reference material that is provided by the supervisor, manager or director.
Know and follow the Employee Handbook policies and procedures.
Maintain patient confidentiality so that HIPAA compliance is observed at all times.
Demonstrates honesty and integrity in everyday activities.
Recognizes when an error has been made and immediately reports to appropriate manager.
Maintain regulatory Turn Around Time Standards per CMS (Seniors) and ICE (Commercial).
Maintains quality monitors as assigned by Supervisor.
Assists other staff and supports the team approach.
Participates in the efficient, effective, and responsible use of resources such as supplies and equipment.
Communicates appropriately and clearly to management, coworkers, and physicians.
Other Duties as assigned

The pay range for this position at commencement of employment is expected to be between $18 and $20 per hour; however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, licensure, skills, and experience.

The total compensation package for this position may also include other elements, including a sign-on bonus and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered.

Details of participation in these benefit plans will be provided if an employee receives an offer of employment.

If hired, employee will be in an "at-will position" and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.

As one of the fastest growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare & Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming and supportive work environment.

Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success.

Full Time Position Benefits:

The success of any company depends on its employees.

For us, employee satisfaction is crucial not only to the well-being of our organization, but also to the health and wellness of our members.

As such, we are firmly dedicated to providing our employees the options and resources necessary for building security and maintaining a healthy balance between work and life.

Our dedication to our staff is evident in our comprehensive benefits package. We offer a very generous mixture of benefits, including many employer-paid options.

Health and Wellness: