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Continuum Of Care

Care Coordinator

 

Job summary:

The primary responsibility of the Outpatient Care Coordinator is responsible for performing a variety of customer service or clerical functions for an Outpatient Facility. Answers patient, family, visitor, and insurance inquiries, takes accurate information for client pre-authorization, etc. The Outpatient Care Coordinator contacts insurance providers to verify coverage and benefits. 

 

To provide ongoing support and expertise through comprehensive assessment, planning, implementation and overall evaluation of individual participant’s needs. The overall goal of this position is to enhance the quality of the participant’s management and satisfaction, to promote continuity of care and cost effectiveness through the integrating and functions of case management, utilization review and management and discharge planning. Has accountability for the care, coordination and discharge planning of all participants.

Primary Responsibilities: 

  1. Manage the clients in the program and coordinate services within BBC OP

  2. Track new client referrals

  3. Demonstrates ability to assist and evaluate in the Outpatient admission process.

  4. Collect data related to referrals, discharges, groups, etc.

  5. Documentation of service plans and service delivery according to BBC Policy and Procedures (ensures and/or delegates services entries into electronic medical records system), and supports with insurance billing as needed

  6. Triage phone calls as the first point of contact for families in need of services

  7. Scheduling patients in person and by phone for main office locations

  8. Insurance Verification

  9. Reception/phone coverage

  10. Administrative support for clinical services

  11. Preparing records requests

  12. Starting new clinical files for doctors within our EMR

  13. Filing and scanning closed records

  14. Sending new patient confirmation letter/packets via email/mail

  15. Administrative tasks including mailing, sorting mail, faxing

  16. Opening and closing office procedures

  17. Other general office/administrative support for OP, etc.

  18. Obtain physician/CARES/insurance referral, verify insurance coverage and eligibility, and contact the payer for necessary pre-authorization for services

  19. Collects documentation and patient payments as determined by BBC Accounting

  20. Documents all patient related activity in EMR in an accurate, thorough, and timely manner.

  21. Assists in marketing efforts to build relationships with local referral sources and stakeholders

  22. Communicates with CARES/ADAD.

  23. The Outpatient Care Coordinator participates on the treatment team for an identified caseload of clients to assist with servicing the client caseload needed.

  24. Conducts review for appropriate utilization of services from admission through discharge. Evaluate patient satisfaction and quality of care provided. 

  25. Prepare communications, such as memos, emails, invoices, reports, and other correspondence

  26. Write and edit documents from letters to reports and instructional documents

  27. Create and maintain filing systems, both electronic and physical.

  28. Demonstrate a warm, kind, and compassionate approach toward all client’s, that supports recovery and results in positive consumer outcomes.

  29. Excellent Time Management and Organization Skills

  30. Demonstrates ability to work as a team player by working with other members of the Clinical Team, assisting other team members, as needed.

  31. Collects clinical data and enters information into the appropriate database for tracking purposes.

  32. Documents and maintains records that reflect compliance with state reporting mandates.

  33. Conduct/provide appropriate outreach services including linking to additional services as deemed necessary.

  34. Offer assertive outreach to engage each consumer at their place of choice, in the least intrusive manner possible

  35. Use alternative outreach and engagement approaches in response to varied consumer needs, cultural backgrounds, life stages, or linguistic needs

  36. Acts as liaison and consult with community agencies and families to maintain coordination in the treatment process

 

Other Related Duties:

  1. Participates actively in case reviews, client clinical services, chemical dependency education, professional staff and program training and committees, and assists in any clinical tasks as needed.

  2. Completes other special assignments and projects as assigned.

  3. To participate actively as an agency representative in collaborative partner networks and in related community activities. 

  4. Willingly performs other duties/responsibilities, as requested.

  5. Prepares communications, such as memos, emails, invoices, reports and other correspondence, etc.

  6. To identify learning needs for program and service staff, and assist in providing needed training.

  7. Performs complex administrative tasks closely guided by policy and past clinical practice.

  8. Makes decisions within the scope of the job, consistent with plan/department policy and procedure.

  9. Maintains accurate records of service coordination activities in the stem using clinical guidelines.

  10. Maintains HIPAA standards and confidentiality of protected health information; and reports critical incidents and information regarding quality of care issues. 

Note: The company reserves the right to assign additional duties and to add, delete, or modify an essential or marginal job function. 

 

This job requires strict compliance with all company policies and procedures including but not limited to all state and federally mandated patient privacy laws and regulations (E.g. HIPAA). Job requires maintaining professional relationships with patients consistent with reasonable expectations for a behavioral health practice.

 

Working Conditions:

Indoors, office setting and outdoors settings. .

Mental & Physical Requirements:

Minimal physical effort required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  1. Duties require the use of considerable initiative and judgement

  2. Work under minimal supervision and direction.

  3. Requires working under deadlines and pressure.

  4. Requires working with difficult people or situations.

  5. Establishes and maintains cooperative and productive work relationships.

  6. Requires sitting for an extended period of time.

  7. Requires traveling to various business locations, as required by the job.

 

Communication Demands:

Requires communicating effectively both orally and in writing in the English language, giving instructions or direction to others, and seeking information from a variety of resources.

Skills, Knowledge, Education and Experience:

  1. Bachelor’s degree in one of these specific areas of study: social services/human services, psychology or a combination of relevant education and experience. 

  2. In lieu of a Bachelors Degree, must have high school Diploma, CSAC and/or at least 4 years of experience of services preferred.

  3. Decision-making: have to be able to make independent decisions on a daily basis, addressing the best way to handle specific tasks.

  4. Knowledge of HIPAA standards, responsibilities and procedures.

  5. At least two years of providing field based case management services

  6. Knowledge of client’s rights, state and federal laws, and regulations, such as those relating to health services, confidentiality, and consent issues for the targeted population.

  7. Knowledge of community based resources.

  8. Strong interpersonal and communication skills

  9. Demonstrates ability to motivate clients

  10. Ability to work well in a team environment

  11. Good oral and writing communication skills, must be able to collaborate with other administrators and support personnel, management, and clients on a regular basis.

  12. Knowledge of Microsoft Office including Excel, Word, PowerPoint, and Outlook

  13. Knowledge of data entry, documentation and report generation in any clinical system a plus

  14. A capacity to work collaboratively.

  15. Capable of working with diverse populations.

  16. Non-judgmental.

  17. Reliable transportation

  18. Valid driver’s license with clean driver’s abstract

 

Hours:

Monday-Friday 9;00 am to 5:00 pm