Job Openings >> Operations Coordinator
Operations Coordinator
Summary
Title:Operations Coordinator
ID:1045
Department:Central Intake
Description
Home Health Operations Coordinator

Job Summary The Operations Coordinator performs a variety of duties. This position requires skill in planning, organizing and coordinating the delivery of patient care by myNEXUS monitoring services and approved Home Health, Durable Medical Equipment and Infusion providers.  This person is responsible for processing referrals, determining eligibility for benefits, checking status of authorization, and verification of all information received.  The Operations Coordinator does not conduct any activities that require interpretation of clinical information.
 
Job Requirements
  
  • Receives and coordinates all referrals to include notification of insurance providers for prior authorization and services covered.
  • Assures that all Home Heath (“HH”), Durable Medical Equipment "DME" and infusion orders and faxes are received and processed
 
  • Responsible for processing incoming and outstanding fax processing and assigning to the appropriate myNEXUS team member.
 
  • Using discretion and independent judgment in handling patient or physician complaints received, documents and forwards to appropriate administrative staff.
 
  • Documents all patient activity as directed and maintains electronic and/or hard copy files as directed.
 
  • Responsible for processing new enrollees for the high risk monitoring program, acquiring consent, and scheduling equipment shipment.
 
  • Escalates abnormal situations to supervisor, making recommendations for resolution.
 
  • Communicates with patients and family in a kind and professional manner.
 
  • Gives explanations and verbal reassurances to patient and family.
 
  • Interacts professionally with all, including co-workers and other healthcare providers.
 
  • Fosters communication among healthcare team on the behalf of the patient.
 
  • Proficient with myNEXUS systems, processes data entry, and basic computer skills for generation of daily office communication and record generation.
 
  • Answers the telephone and patient/provider requests in a timely and polite manner.
 
  • Communicates ideas for improvement to the supervisor.
 
  • Demonstrate proficiency in meeting and exceeding all required departmental goals and objectives.
 
  • Reflects knowledge and judgment in decisions and actions within the job description of the Operations Coordinator.
 
  • Must be able to demonstrate team behavior and must be willing to promote a team-oriented environment. 
 
  • Demonstrates high level customer service skills, both internally and externally.
 
  • Accepts additional assignments willingly.
 
  • Supports the Mission and the Core Values of myNEXUS
  • Performs other duties as assigned.

 Educational Requirements:
             
High School diploma or the equivalent.


Experience Requirements:

Experience in the following areas is ideal for this position: Medical Assistant, Home Health Office Coordinator, Hospital or Home Health Admissions Representative, Operations Coordinator, Medical Transcriptionist, or any similar administrative role in a healthcare setting.  Incumbents must be familiar with medical terminology and have outstanding customer service skills.
 
Language Skills:
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  • Ability to read and communicate effectively in English.  Additional languages preferred.
  • Ability to read, analyze, and interpret insurance and medical documents.
  • Must understand and communicate effectively with providers and insurance representatives. 
  • Ability to respond to common inquiries or complaints from providers, patients or family members. 
  • Must demonstrate the willingness to work in a team environment and be a team player
  • Possesses the ability to adjust to constantly changing work flows and processes. 
 
Reasoning Ability:

Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to recognize clinical documentation form a verity of sources and determine the appropriate process to follow. 
 
Other Skills:
  • Medical terminology
  • Home Health experience preferred
  • Healthcare operations knowledge; insurance eligibility & verification processes
  • Basic understanding of medical insurance, particularly Medicare Advantage plans
  • Basic computer knowledge such as Word, Excel, PowerPoint, Outlook, and others.
  • Strong administrative, clerical and organizational skills
  • Excellent customer service and follow-up skills
  • Strong attention to detail and accuracy.

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