Inpatient Coordinator After Hours (TEMP)

Position Summary:

 

The After Hours Coordinator supports the process that manages the Afterhours Call Department. The goal for this position is to effectively support the Afterhours Call Services management process by assuring the right information is provided timely to the team. This includes ensuring that all necessary clerical functions are completed accurately and timely.  Assist in facilitating referrals, transfers and authorizations. Relates and communicates well over the telephone to all callers.

 

Essential Duties and Responsibilities include the following:

• Receives and responds to telephone calls from members and providers.
• Verify eligibility and benefits and communicate to the nurse.
• Generates authorizations for hospitals, vendors and/or outside services as directed.
• Receives and responds to telephone calls from hospitals, vendors and physicians requesting facilitation of requested services.
• Directs caller to appropriate Triage nurse.
• Documents all calls according to established standards.
• Translates oral information into concise and accurate written documentation.
• Demonstrates customer service-oriented behavior at all times.
• Expedites emergency calls as needed.
• Accesses Language Line for non-English speaking patients as needed
• Participates in regular staff meetings as scheduled.
• Uses, protects, and discloses patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
• Consistently exhibits behavior and communication skills that demonstrate commitment to superior customer service, including quality, care and concern with each and every internal and external customer.
• Ensures all approved authorizations are entered accurately into the system.
• Maintain accurate and timely records in REA. Scan physician progress notes, reports, and records and attach documents to appropriate authorizations.
• Update and close cases in a timely manner.
• Communicate immediately any admissions to non-contracted or non-core facilities.
• Distribute face sheet immediately upon receipt and eligibility check to the appropriate nurse.
• Check all new admissions for Out of Area status.
• Review case statuses to ensure proper documentation and case closure. Work with assigned nurse to complete all documentation.
• Communicate with supervisor regarding any potential issues.
• Prepares appropriate denial letter at the direction of the Nurse
• Maintains confidentiality of all patients and medical/clinical information.
• Identify network needs and report to management for potential contracting opportunities.
• Monitor incoming fax server and flag each fax appropriately to ensure proper routing.
• Acts as a mentor as requested by supervisor.
• All other duties as directed by management.

The pay range for this position at commencement of employment is expected to be between  $21 - $23 per hour; however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, licensure, skills, and experience.

 

The total compensation package for this position may also include other elements, including a sign-on bonus and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered.

 

Details of participation in these benefit plans will be provided if an employee receives an offer of employment.

 

If hired, employee will be in an “at-will position” and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.

 

As one of the fastest growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare & Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming and supportive work environment. Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success.

 

Employer will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the LA City Fair Chance Initiative for Hiring Ordinance.

Qualifications

Educati