Diagnostic Coordinator at Grace Health

Summary: 

Responsible to coordinate and complete specialty and diagnostic services in a timely and efficient manner for Grace Health patients; and obtain prior authorizations when indicated.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

JOB SPECIFIC DUTIES:

• Coordinate all aspects of a specialty and/or diagnostic referral in a timely manner when requested by Grace Health providers.
• Check the diagnosis code on the orders to make sure they meet insurance guidelines and are medically necessary.
• Call and schedule patient’s test and inform the patient on when and where to go.
• Verify insurance coverage and obtain prior authorizations for services to be rendered as required by individual insurance plans.
• Ensure that the specialist accepts the patient’s insurance plan.
• Assemble referral paperwork and requested medical information and submit to the specialty office as needed.
• Communicate referral information to the patient and providers.
• Document appointment or preauthorization information in Nextgen EMR or in an electronic log of all referrals.
• Provide excellent customer service to both internal and external customers. 
• Establish and maintain professional relationships with all staff.
• Inform leadership of authorization or referral concerns, back logs, or insurance issues.

GENERAL DUTIES:

• Follows policies and procedures of the office, including administrative, clinical, quality assurance, and personnel
• Maintain good attendance (daily, meetings, and other assignment tasks)
• Maintain timely documentation of all work assignments
• Maintain patient confidentiality
• Routinely keep supervisor informed about attendance and job assignments
• Flexible in being able to multitask
• Work effectively and at an efficient pace
• Work cooperatively with physicians, administration, and peers

OTHER ESSENTIAL DUTIES and RESPONSIBILITIES:

• Grace Health recognizes that managing patient care is a team effort that involves clinical and non-clinical staff.  All employees must embrace a team-based approach to patient care and understand that each role is important to our success. 
• Team members must demonstrate excellent team communication and coordination to provide quality patient care.
• Care coordination includes communicating with community organizations, health plans, facilities, and specialists.
• Care team members understand and embrace the concept of population management and proactively address the needs of patients and families served by this practice. 
• Team members must demonstrate skill and knowledge related to effective communication with vulnerable patient populations.
• Team members must participate in Continuous Quality Improvement activities within the organization to ensure patients receive high quality care.
• All team members will be involved in the process of improving quality incomes.
• Team members will participate in the review and evaluation processes of practice performance and help to identify opportunities for improvement.
• Team members will participate in Grace Health's advocacy program.

GENERAL DUTIES:

• Follows policies and procedures of the office, including administrative, clinical, quality assurance, and personnel
• Maintains good attendance (daily, meetings, and other assignment tasks)
• Maintains timely documentation of all work assignments
• Maintains patient confidentiality
• Routinely keeps supervisor informed about attendance and job assignments
• Flexible in being able to multitask
• Works effectively and at an efficient pace
• Works cooperatively with providers, administration, and peers

QUALIFICATION REQUIREMENTS:

To perform this job successfully, an individual must be able to assist in advancing Grace Health’s mission and 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.

SKILLS:

• Pleasant personality and professional demeanor
• Cooperative attitude-Flexible
• Detail Oriented
• Able to work with minimal supervision
• Highly organized work habits with ability to prioritize
• Intermediate computer skills with Microsoft Word and Excel
• Familiar with Electronic Medical Record

EDUCATION and/or EXPERIENCE: 

Must have completed high school or equivalent.  Must have past experience with Referrals and Authorizations.  Prefer 1 year Medical Office experience. Prefer RMA or CMA

BENEFITS:

• Safe harbor 401(k) with match potential
• Paid time off
• Family friendly work environment
• Health insurance
  • Wellness program
  • Health savings account
  • Pharmacy benefit
  • Employee visits for medical services
• Dental insurance
• Vision insurance
• Life Insurance
• STD/LTD
• EAP & Work life services
• Voluntary benefits
• Hospital indemnity