Care Coordination Center Representative

Job Details: Job Location: Windber Hospital Inc - Windber, PA, Position Type: Full Time, Education Level: High School, Salary Range: Undisclosed, Travel Percentage: Negligible, Job Shift: Day, Job Category: Admin - Clerical, The Care Coordination Center will provide a centralized, consistent, and patient-focused approach to handling incoming calls and clinical inquiries for the practice. They will use clinical judgment within the scope of their license and established practice protocols to determine the appropriate response to patient needs and ensure timely communication with providers and clinical staff. Position Overview: The Care Coordination Center is responsible for coordinating and managing the day-to-day operations of the Call Coordination Center, serving as a central point of contact for patients. This position combines medical and nursing knowledge with high-level patient communication, telephone triage, scheduling, prescription refill coordination, and administrative support. This position will work closely with LPN’s and MA’s.  KEY RESPONSIBILITIES: Patient Calls & Call Center OperationsAnswer and manage incoming patient calls in a professional, courteous, and timely manner.Serve as the primary point of contact for patients calling the practice.Identify the reason for each call and appropriately address, route, or escalate the patient's needs.Provide patients with clear information regarding office procedures, appointments, medications, and other appropriate non-diagnostic questions.Document all patient interactions accurately in the electronic medical record (EMR).Maintain a high level of customer service and professionalism with every patient interaction.Assist in establishing and maintaining Care Coordination Center workflows, protocols, and standards. Nurse Line / Clinical Patient QuestionsManage the centralized nurse line and respond to patient clinical questions within the scope of practice and established protocols.Obtain appropriate information from patients to understand their concerns.Provide approved nursing guidance and patient education as directed by practice protocols.Identify urgent or potentially concerning symptoms and appropriately escalate calls to a provider or clinical staff.Communicate patient concerns and messages to physicians, nurse practitioners, physician assistants, or other appropriate clinical personnel.Follow established protocols for urgent, same-day, and routine patient concerns.Ensure appropriate follow-up and documentation of clinical telephone encounters. Scheduling & Appointment ManagementSchedule new and established patient appointments.Reschedule and cancel appointments as requested if appropriate.Assist patients in determining the appropriate appointment type, provider, and timeframe based on established office guidelines.Coordinate urgent and same-day appointments when appropriate.Communicate appointment information and instructions to patients.Assist with managing appointment-related calls and patient questions. Prescription Refill ManagementReceive and process medication refill requests according to established practice protocols.Review refill requests for required information and route requests appropriately.Communicate with providers and clinical staff regarding refill requests requiring review or authorization.Communicate with pharmacies and patients when necessary.Document prescription-related communications accurately in the EMR.Escalate refill requests that require clinical review or provider intervention. Administrative & Document ManagementUpload incoming faxes into the appropriate electronic medical records or document management system.Scan and index medical records and other documents accurately.Route documents, faxes, and clinical information to the appropriate office, provider, or staff member.Assist with maintaining organized and accurate electronic patient records.Monitor incoming documentation to ensure timely processing and appropriate follow-up.Support individual practice offices with centralized administrative and clinical communication needs.Obtain prior-authorization for medications and/or testing for procedures. Communication & Care CoordinationServe as a communication link between patients, providers, nurses, medical assistants, front-office staff, pharmacies, and other members of the healthcare team.Ensure messages are complete, accurate, and directed to the appropriate individual or department.Follow up on outstanding patient messages when required.Help reduce unnecessary transfers and improve the overall patient experience by resolving issues whenever possible at the Care Coordination Center level.Maintain confidentiality and comply with HIPAA and all applicable organizational policies and procedures. Other duties as assigned.Qualifications: Education/Training/License/Certification:Currently licensed as an LPN or MA in the Commonwealth of Pennsylvania is highly preferred. Equivalent experience will be considered in lieu of certification.Ability to multi-task and manage a high volume of calls while maintaining professionalism Strong telephone and customer service skills are requiredProficiency with electronic medical records is also required  Work Experience:Minimum one year working in a physician office, hospital, or medical coordination center is desired.