We are currently looking for a(n) Coordinator Referred Care-Contract Health-AMO located at the AMO Salina Clinic.
JOB SUMMARY
Responsibilities include establishing, implementing, maintaining, and evaluating the Referred Care Services program for the assigned area including making referrals, setting up appointments with vendors, and processing required paperwork. Patient education regarding RCS processes and policies.
RESPONSIBILITIES
Establishes, implements maintains and evaluates the Referred Care Services program for the assigned area. Makes recommendations and state concerns to the rural health center Referred Care Services Supervisor and Manager where applicable. Develops and administers the purchased patient services for the facility by working closely with clinicians and processing referrals. Schedules appointments for the patient with the vendor and gathers information that will be needed by the patient and vendor. Notifies appropriate personnel of vendor costs above the normal fee range. Maintains filing as required. Verifies patient eligibility and makes notifications of denials. Educates patients regarding Referred Care Services processes and policies. Coordinates and utilizes third-party resources for patient care services provided outside the rural health center. Refers uninsured patients to the Patient Benefit Coordinators for evaluation of resources for which patients could be eligible at low or no cost. Manages the automated RPMS manage care system and related databases by transferring data between the two databases. Processes vendor invoices by submitting them to the Referred Care payables as required. Maintains a vendor list, which identifies private vendors and services provided. Notifies patients and providers when a chosen vendor is not in-network. Makes reports as required. Monitors expenses closely and keeps appropriate personnel up to date. Other duties as assigned.
QUALIFICATIONS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
EDUCATIONAL REQUIREMENT One-year certificate from college or technical school; or 1-1/2 years of related experience; or an equivalent combination of education and experience.
EXPERIENCE REQUIREMENT At least three (3) years of experience in a related field.
LANGUAGE SKILLS Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public. MATHEMATICAL SKILLS Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volumes. Ability to apply concepts of basic algebra and geometry. COMPUTER SKILLS To perform this job successfully, an individual should know database software, internet software, spreadsheet software, and word processing software
REASONING ABILITY Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
CERTIFICATES, LICENSES, REGISTRATIONS Completion of health-related courses or the study of medical terminology is preferred.