Overview of the Role:
Alignment Health is seeking an organized, detail oriented, and compassionate remote bilingual Spanish care coordinator to join the Care Anywhere (CAW) team. As a care coordinator you will be providing care coordination for members by supporting providers in the field. You get to work collaboratively with other care coordinators, physicians, physician assistants, nurse practitioners, LVN’s, RN’s, health coaches, and social workers. If you have experience as a front office medical assistant, have a passion to serve, and want to be a part of an organization that is positively impacting the lives of seniors – we’re looking for you!
Responsibilities:
- Review daily census for new admissions
- Obtain medical records from provider offices, hospitals, and skilled nursing facilities (SNF)
- Attach medical records to authorizations
- Enter referral requests / authorizations in system
- Monitor fax folders
- Monitor task lists in EHR
- Creates cases and tasks in case management module for hospital and SNF discharges.
- Post discharge scheduling of appointments
- Follow up scheduling and re-scheduling of no-show appointments
- Assist nurse practitioner (NP) team with visit preparation needs
- Appointment reminders to members
- Assign members to NP in EHR
- Enter all medications and allergies in EHR
- Provide needed documentation to NP for visits each day
- Direct inbound calls from members / family related to medication refills
- Assist in hospice enrollments
- Complete and document tasks assigned by nurse.
- Maintain documentation on members contacted.
- Assist with COC’s
- Notify NP / nurse If members appear to be non-compliant or there appears to be a change in condition
- Assist with outreach activities to members in all levels of case management programs.
- Assist with maintaining and updating member’s records
- Assist with mailing or faxing correspondence to primary care physician (PCP) and specialists
- Assist with mailing correspondence to members, related to CCIP activities
- Attend and participate in case management presentations.
- Identify work-related problems and contribute to solutions.
- Meet deadlines (respond to various workloads by assigning task priorities according to department policies, standards and needs).
- Work with outside vendors to provide appropriate care needs for members
- Maintain confidentiality of information between and among health care professionals.
- Communicate with multi-disciplinary teams
- Cover for other team members when needed (i.e. PTO, sick time)
Required Skills and Experience:
- Minimum (1) year front office medical assistant, related experience, and / or training; or equivalent combination of education and experience.
- Experience entering referrals and prior authorizations highly preferred.
- Call center and scheduling experience.
- Experience with high call volume (50 + calls / day)
- Experience with Access Express / Portal, Epic, Essette preferred.
- Knowledge of medical terminology.
- Knowledge of ICD9 and CPT codes
- Knowledge of Managed Care Plans
- High school diploma or general education degree (GED)
- Medical terminology certificate preferred
- Organized and detail-oriented
- Able to type minimum 40 words per minute (WPM)
- Proficient in Microsoft Office (Outlook, Excel, Word)
- Good interpersonal skills.
- Able to read, write, and speak English fluently.
- Bilingual English and either Spanish or Vietnamese required.
- Solid written, verbal, and telephonic communication skills
- Able to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals. Able to write routine reports and correspondence. Communicates effectively using good customer relations skills. Able to file systematically.
- Able to add and subtract two-digit numbers and to multiply and divide with 10’s and 100’s. Able to perform these operations using units of American money and weight measurement, volume, and distance.
- Able to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Able to deal with problems involving a few concrete variables in standardized situations. Able to reason and carry out instructions.
PAY RANGE: $41,100 - $54,080 annually
