Managed Care Coordinator - SouthPark Sleep Medicine

Primary Job Responsibilities/Tasks may include, but not limited to:
The duties and responsibilities of this position include assisting patients and providers with coordinating of referrals, obtaining authorization and scheduling. This position is also responsible for understanding benefits coverage and ensures the patient’s care is coordinated.

(This is a full-time position supporting our Sleep Medicine team at SouthPark, Monday to Friday 8 am to 5 pm)

Responsibilities:

Completes referrals for patients and coordinates with referring and receiving practices, departments and outside facilities.
Obtains prior authorizations for sleep studies.
Reviews benefits and educates patient on insurance coverage.
Educates patients on step-by-step Watchpat guidance, making sure device is used properly.
Schedules appointments for Watchpat pickup.
Follows up on all referrals to ensure no care gaps.
Ensures sleep billing encounter is placed.
Handle sensitive information in a confidential manner.
Other duties as assigned.

Requirements:

Education, Experience and Certifications:

High School Diploma or GED required.
Thorough understanding of insurance coverage and Medical Necessity policies preferred.
Customer service experience required.
Knowledge of medical records software preferred.
Completion of Hepatitis B Vaccine and Flu Vaccine Form will be required. Candidate may decline vaccination through declination form or may provide record of vaccination from previous employer.
Completion of TB test will be required.

Physical Requirements:

Work consistently requires walking, standing, sitting, lifting, reaching, stooping, bending, pushing, and pulling.
Must be able to lift and support weight of 35 pounds
Ability to concentrate on details.
Use of computer for long periods of time.

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