We are looking for highly motivated individuals to join our ever growing team here at Bingham. You must be willing and able to learn new skills and adapt to change often, as the medical field is ever changing. You must have good communication skills and be detail oriented. We have multiple providers of all specialties and are located in several of our surrounding areas. If you are looking for a rewarding and fulfilling career and enjoy fast paced environments this will be a good fit for you.
JOB REQUIREMENTS
Minimum Education: High School Diploma or equivalent. Associates or Bachelor's degree in business related field preferred.
Minimum Work Experience: One (1) years' experience in hospital billing preferred. Previous experience in pre-certification and prior authorizations in a hospital setting highly preferred.
Required Skills, Knowledge, and Abilities: Excellent verbal communication skills, computer skills and ability to multitask. Must be able to use Microsoft Office, Word, and Excel. Adapts to EMRs quickly. General mathematics.
The Care Coordinator - Medicare Advantage position on the Population Health team focuses on helping our Medicare Advantage patients. This position seeks to help Medicare Advantage patients as well as the clinics that serve these patients.
Patient-Facing Duties
- Contact patients regarding annual wellness visit opportunities
- Contact patients and other healthcare providers regarding care gaps (cancer screenings, immunizations, lab results, and other information)
- Help connect patients with services in our health system as well as services in the community
- Help these patients connect with services on the Population Health team as appropriate (chronic care management, post-acute care management, pharmacological consultations, education, etc.)
- Document the closure of care gaps on patients' medical records
- Other duties as they become applicable
Clinic-Facing Duties
- Be aware of upcoming clinic visits for Medicare patients, and provide the clinics with any needed information or objectives that will aid those visits
- Help clinics as needed with tracking down needed information for patients
- Inform clinics of additional resources for high risk patients (resources on the Population Health Team, resources in our health system, community resources, etc.)
- Attend primary care clinic huddles as needed to communicate with and serve the primary care clinics
- Other duties as they become applicable
Duties to Third Parties
- Meet with the commercial insurance payors who administer Medicare Advantage plans; review patient populations, review Bingham's performance, and work with them to help Bingham succeed in managing attributed patients.
- Become skilled at navigating the various payor web portals to view patient data and care gap opportunities, and also how to upload evidence that care gaps have been closed.
Helpful Skills and Experience
Below is a list of helpful skills and experiences that a candidate needs to have or will need to acquire in order to succeed in this role:
- Consistent, pleasant, and helpful customer service skills. A "customer" is anyone this position serves, including patients but also including clinics, providers, and anyone else that needs coordination help. Must be professional on the phone and in person.
- Solid team collaboration skills - every day, this position will communicate and collaborate with several people on the Population Health Team and many people across our health system. Not a position for those that like to work solo.
- Communication skills - can explain things to others simply and clearly, and listen as well. Can be well informed in order to have productive conversations with providers.
- Computer skills - can learn EHR and scheduling software; email, messaging, and video conferencing platforms; and various web portals in order to retrieve patient data. Ample opportunity will be given for learning and orientation, but this role will rely on these computer abilities daily.
- Integrity - must be honest, must be reliable, and must take pride in doing good work and providing good service.
- Adaptability - the Population Health Team tackles performance and process improvement projects frequently. Must be open to trying new workflows, and must have an understanding that objectives and responsibilities are more important than the way something has always been done, especially if changes can help us better achieve those objectives and responsibilities.
- Understanding of value-based care - we help the people that need to go to the hospital, but our aim is to also help other high-risk patients to better control their conditions to prevent the risk they'll need to go to the hospital. We aim to help people thrive as much as we can.
Other Abilities
- Treats patients and their families with respect and dignity. Identifies and addresses psychosocial, cultural, ethnic, and religious/spiritual needs of patients and their families. Functions as a liaison between patients, physicians, and other healthcare providers.
- Consults other departments as appropriate for an interdisciplinary approach to patient needs.
- Maintains a good working relationship both within the department and with other departments within the Bingham Healthcare organization and our Partners.
- Documentation meets current standards and policies.
- Flexible and organized, can function well under stressful conditions.
- Completes annual education requirements and evaluations.
- Maintains regulatory requirements.
- Always maintain patient confidentiality.
- Reports to work on time and as scheduled, completes work within designated time.
- Represents the organization in a positive and professional manner.
- Complies with all organizational policies regarding ethical business practices.
- Maintain flexibility in a growing environment and be willing to grow, change and accept new duties as the scope of our department changes with the needs of the community and healthcare system.
- Solid understanding of HCC coding and quality measures of all payors.
- Understands care gap rosters.
- Must have sensitivity, maturity, and ability to communicate clearly and concisely, both verbally and in writing. Must be patient, courteous, compassionate, and respectful with patients, their families, coworkers, physicians, and administrative staff. Ability to communicate and relate well with physicians, staff, and management.
- Organized, detail oriented and has the capacity to manage many patients.
Participates in provider led clinic huddles.