Senior Patient Care Coordinator - Wayzata, MN

Purpose:

The Senior Patient Care Coordinator is responsible for delivering a seamless and supportive patient experience by managing all aspects of patient communication, scheduling, clinical coordination, insurance processes, and financial counseling. This role supports patients throughout the full continuum of care—from initial inquiry to post-operative follow up—while partnering closely with physicians, clinical staff, leadership, and external partners. The Senior Patient Care Coordinator also participates in sales consultations, referral development, and operational support to ensure efficient clinic flow and high patient satisfaction.

Key Responsibilities:

Patient Communication & Lead Management

• Receive and respond to incoming phone calls, internet inquiries, and online leads; provide service education and schedule consultations, procedures, and follow‑up appointments.
• Conduct timely follow‑up on all phone and electronic leads and proactively reach out to under‑contacted individuals in the patient database.
• Build rapport with prospective patients through effective communication, education, and relationship‑focused service.

Consultations, Sales & Treatment Coordination

• Participate in and observe patient consultations; conduct sales consultations and guide patients through treatment options.
• Present physician‑directed surgical and treatment quotes, ensuring patients understand clinical recommendations and cost details.
• Schedule surgeries, cosmetic procedures, and related services in alignment with physician availability and patient preferences.
• Verify facility fees, anesthesia costs, implants, garments, and other supplies to ensure accurate, complete estimates.

Insurance Coordination, Financial Counseling & Authorizations

• Verify patient insurance benefits and communicate financial responsibilities clearly and accurately.
• Provide financial counseling, explaining coverage limitations, out‑of‑pocket expenses, payment expectations, and financing options.
• Manage prior authorizations, pre‑certifications, and insurance coordination in collaboration with carriers and clinical providers.
• Support patients in navigating benefits, authorizations, and payment processes to ensure understanding and confidence prior to treatment.

Insurance Appeals & Medical Necessity Documentation

• Analyze insurance determinations, denial rationales, and coverage requirements.
• Draft letters of medical necessity and prepare supporting documentation for appeals.
• Coordinate peer‑to‑peer reviews between providers and insurance medical directors to resolve authorization barriers.

Payer & Vendor Collaboration

• Serve as a liaison between the clinic, insurance carriers, and external authorization vendors.
• Participate in discussions with payer representatives to address policy interpretation, authorization challenges, and workflow improvements.

Payer Policy Monitoring & Authorization Strategy

• Monitor payer trends, coverage guidelines, and authorization requirements.
• Identify patterns in approvals and denials; collaborate with leadership to refine submission strategies and improve success rates.

Internal Insurance Expertise & Training

• Serve as the primary internal resource for insurance authorization processes and payer requirements.
• Provide training, guidance, and ongoing education to staff on insurance workflows and documentation standards.

Clinical & Administrative Support

• Scribe for physicians during consultations and re‑check visits; maintain accurate and timely clinical documentation.
• Support clinic flow including room turnover, patient readiness, and general operations.
• Sterilize medical instruments, sanitize exam and procedure rooms, and ensure proper disposal of medical and hazardous waste.
• Assist with laundering and preparing patient gowns, bedding, towels, and related materials.

Operational Coordination & Documentation

• Maintain accurate CRM entries, patient records, and EMR financial documentation.
• Prepare reports, track leads, update patient statuses, and use software systems for scheduling, reporting, and workflow management.
• Participate in meetings with physicians, leadership, and clinical teams to review processes and improve operational performance.
• Shadow and learn clinical workflows to continually enhance patient coordination and care experience.
• Ensure timely completion of tasks, organized workflow management, and professional executio