About this role
At SCP Health, what you do matters As part of the SCP Health team, you have an opportunity to make a difference. At our core, we work to bring hospitals and healers together in the pursuit of clinical effectiveness. With a portfolio of over 8 million patients, 7500 providers, 30 states, and 400 healthcare facilities, SCP Health is a leader in clinical practice management spanning the entire continuum of care, including emergency medicine, hospital medicine, wellness, telemedicine, intensive care, and ambulatory care.
Why you will love working here: - Strong track record of providing excellent work/life balance. - Comprehensive benefits package and competitive compensation. - Commitment to fostering an inclusive culture of belonging and empowerment through our core values - collaboration, courage, agility, and respect.
RESPONSIBILITIES:
• Work efficiently and in a professional manner utilizing multiple forms of engagement (blended inbound/outbound calls, chat, SMS/Text, and email) in a fast paced and challenging contact center environment across multiple lines of business. • Manage general inquiries, track appointments, remind patients of appointments, and follow all processes and procedures while demonstrating sensitivity to any issues. • Serves as a navigator to the clinic/hospital for insurance companies or insurance utilization review department by providing clinical information to obtain pre-certification from payers/adjusters/nurse case managers for workers’ compensation referrals. • Intake accurate collection of data to complete the coordination of care/referral for program service lines (occupational health services and workers compensation visits). • Assist and track referrals/appointment scheduling, prior authorizations, and/or insurance billing verification, when applicable for tests/procedures, including surgical procedures, diagnostic procedures, provider appointments, outpatient rehab services, etc. • Assemble information concerning referral needs to assist with expediting and coordinating care. • Per client referral guidelines, provide information to appropriate parties to assist with referral navigations/care coordination within client’s health system/hospital. • Responsible for staying abreast of state specific worker’s compensation and occupations health laws and regulation. • Check eligibility and obtain authorization for ordered services via insurance companies or acceding vendor portals. • Track and reconcile patient referral orders for assigned areas with follow through to completion, such as return to work regular duty or maximum medical improvements (MMI). • Contact utilization review organizations and insurance companies (adjusters and nurse case managers) to ensure prior approval requirements are met. Present necessary medical information such as clinical notes, orders, and/or referrals for said services. • May assume advocate role on the patient's behalf with the carrier to ensure approval of the necessary services for the patient in a timely fashion. • Utilize client department service lines and identified service providers to coordinate care. Establish and maintain relationships with identified service providers, work comp adjusters and nurse case managers. • Ensure that referrals are addressed in a timely manner and track all referral outcomes. • Communicate and remind patients, employers, adjusters, and nurse case managers of scheduled appointments. • Meet key performance goals including call handling metrics, quality performance, and attendance. • All other duties as assigned.
QUALIFICATIONS: Education:
• High School Diploma or equivalent required • Medical Office Administration experience or Medical Assistant Certification preferred
Certification and Licenses:
• Medical Assistant Certification preferred
Previous Experience:
• Two years’ patient care coordination or patient scheduling experience or equivalent • One year customer service experience • Previous occupational health, or workers compensation experience preferred • EMR experience a plus Knowledge Skills and Abilities:
• Thrives working in fast based, changing, and growth-oriented environment • Ability to quickly learn new processes and workflows • Ability to listen to caller while entering data and documenting information accurately • Strong communication skills, oral and written • Great active listening skills • Patient and empathetic attitude • Excellent interpersonal skills • Computer literate with attention to detail and the ability to learn new software applications and methods of engagement • Problem solving abilities • Excellent customer service skills • Bilingual a plus but not required
Pay Range: 13.00 - 19.00 USD per hourThis range represents the anticipated base salary for this role. Actual compensation will be determined based on experience, qualifications, and internal equity considerations. - We offer a comprehensive benefits package designed to support your health, financial well-being, and work-life balance, including medical dental, vision insurance, a 401(k) plan with a company match, paid time off and holidays, professional development support, and employee wellness resources. Visit our website for further information. https://myscpbenefits.com/ Login name: corp-guest Password: weheal