At SCP Health, what you do matters
As part of the SCP Health team, you have an opportunity to make a difference. At our core, we work to bring hospitals and healers together in the pursuit of clinical effectiveness. With a portfolio of over 8 million patients, 7500 providers, 30 states, and 400 healthcare facilities, SCP Health is a leader in clinical practice management spanning the entire continuum of care, including emergency medicine, hospital medicine, wellness, telemedicine, intensive care, and ambulatory care.
Why you will love working here:
- Strong track record of providing excellent work/life balance.
- Comprehensive benefits package and competitive compensation.
- Commitment to fostering an inclusive culture of belonging and empowerment through our core values - collaboration, courage, agility, and respect.
RESPONSIBILITIES:
- Work efficiently and in a professional manner utilizing multiple forms of engagement (blended inbound/outbound calls, chat, SMS/Text, and email) in a fast paced and challenging contact center environment across multiple lines of business.
- Manage general inquiries, track appointments, remind patients of appointments, and follow all processes and procedures while demonstrating sensitivity to any issues.
- Serves as a navigator to the clinic/hospital for insurance companies or insurance utilization review department by providing clinical information to obtain pre-certification from payers/adjusters/nurse case managers for workers’ compensation referrals.
- Intake accurate collection of data to complete the coordination of care/referral for program service lines (occupational health services and workers compensation visits).
- Assist and track referrals/appointment scheduling, prior authorizations, and/or insurance billing verification, when applicable for tests/procedures, including surgical procedures, diagnostic procedures, provider appointments, outpatient rehab services, etc.
- Assemble information concerning referral needs to assist with expediting and coordinating care.
- Per client referral guidelines, provide information to appropriate parties to assist with referral navigations/care coordination within client’s health system/hospital.
- Responsible for staying abreast of state specific worker’s compensation and occupations health laws and regulation.
- Check eligibility and obtain authorization for ordered services via insurance companies or acceding vendor portals.
- Track and reconcile patient referral orders for assigned areas with follow through to completion, such as return to work regular duty or maximum medical improvements (MMI).
- Contact utilization review organizations and insurance companies (adjusters and nurse case managers) to ensure prior approval requirements are met. Present necessary medical information such as clinical notes, orders, and/or referrals for said services.
- May assume advocate role on the patient's behalf with the carrier to ensure approval of the necessary services for the patient in a timely fashion.
- Utilize client department service lines and identified service providers to coordinate care. Establish and maintain relationships with identified service providers, work comp adjusters and nurse case managers.
- Ensure that referrals are addressed in a timely manner and track all referral outcomes.
- Communicate and remind patients, employers, adjusters, and nurse case managers of scheduled appointments.
- Meet key performance goals including call handling metrics, quality performance, and attendance.
- All other duties as assigned.
QUALIFICATIONS:
Education:
- High School Diploma or equivalent required
- Medical Office Administration experience or Medical Assistant Certification preferred
Certification and Licenses:
- Medical Assistant Certification preferred
Previous Experience:
- Two years’ patient care coordination or patient scheduling experience or equivalent
- One year customer service experience
- Previous occupational health, or workers compensation experience preferred
- EMR experience a plus
Knowledge Skills and Abilities:
- Thrives working in fast based, changing, and growth-oriented environment
- Ability to quickly learn new processes and workflows
- Ability to listen to caller while entering data and documenting information accurately
- Strong communication skills, oral and written
- Great active listening skills
- Patient and empathetic attitude
- Excellent interpersonal skills
- Computer literate with attention to detail and the ability to learn new software applications and methods of engagement
- Problem solving abilities
- Excellent customer service skills
- Bilingual a plus but not required
Pay Range:
$14.45 - $27.02
This range represents the anticipated base salary for this role. Actual compensation will be determined based on experience, qualifications, and internal equity considerations.
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We offer a comprehensive benefits package designed to support your health, financial well-being, and work-life balance, including medical dental, vision insurance, a 401(k) plan with a company match, paid time off and holidays, professional development support, and employee wellness resources.
Visit our website for further information. https://myscpbenefits.com/
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