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SalaryThe RN Care Coordinator provides a collaborative approach with nursing, pharmacy, sales and the Revenue Cycle Management department to ensure timely onboarding and ongoing reimbursement of services for all specialty care patients throughout the duration of therapy.
THIS ROLE IS FOR THE FOLLOWING STATES ONLY: NJ, NH, ME, VT, MD, NC, VA, WV, DE, RI, FL
Essential Duties & Responsibilities:
- Coordinates patient care to meet the needs of complex specialty care patients.
- Manages referrals within a team environment and directs the process of these accounts to ensure they are on-boarded in a timely manner.
- Responsible for the timely and complete on boarding process which includes obtaining all required intake documentation and discussing the financial obligations of the patient associated with the service.
- Serve as a resource and problem solver for patients and their caregivers, nurses, pharmacists, reimbursement coordinators, intake and insurance coordinators payer relations personnel, sales and marketing representatives, patients and their caregivers.
- Provides a collaborative approach between patient and provider to advocate for professional excellence and quality outcomes.
- Develop and maintain ongoing relationships with key professionals at payor sources in an effort to provide education regarding Pentec’s services. Pursue out of network or participate in peer reviews when needed to ensure reimbursement for our services
- Attends appropriate educational in-services as directed by supervisor
- Supports and adheres to HIPAA guidelines and Pentec Health policies and procedures with respect to patient privacy practices and standards of care.
Skills, Competencies and Experience:
Required
- Experience with intrathecal or hepatic artery pump therapy
- Knowledge of insurance process and intake coordination
- Excellent communication and customer service abilities
- Excellent organizational and process skills
- Ability to work under pressure and meet timelines
- Familiarity with Joint Commission standards
- Thorough understanding of HIPAA requirements
Preferred
- 3-5 years of case management experience
- 3-5 years of clinical experience in home infusion therapy
- Proficiency with CPR+
- Skilled in medical billing and reimbursement
Education, Certifications, Trainings:
Required
- Current licensure as a Registered Nurse and the ability to obtain and maintain all required state licensures for your Region: East Compact Licensure plus CT, DC, NY and MA
- College degree or a minimum of 3-7 years’ experience in a related field such as intake, customer service, complete verification/authorization of benefits, billing & collections for home infusion therapies, durable medical equipment or health insurance background are required
Preferred
- Exceptional computer skills with programs such as Microsoft Office Suite: Outlook, Word, Excel and Power Point
- BSN or equivalent experience
Physical requirements:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time. This job description reflects management's assignment of essential functions; it does not prescribe or restrict the tasks that may be assigned. By signing below, I acknowledge that I have reviewed this job description with the associate listed above.
Pentec Health provides a comprehensive compensation and full benefits package. The estimated full-timebase annual salary $65,000-$75,000,actual salary will be based on several factors such as qualifications and skills for the role plus geographic location.
Benefits include but are not limited to: medical, dental, vision, 401k match, PTO, paid holidays, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefit
