Clinical Coordinator - Patient Engagement Center

Job description

Department/Unit: Patient Engagement Center Work Shift: Day (United States of America) Salary Range: $59,066.00 - $88,599.00 The Clinical Triage/Authorization Nurse will assist the Patient Engagement Center Pre-Service as the first point of contact for the Primary Care Pod (ADULT and Pediatrics) for assessment of need of sick visit and trigger words identified through the patient/parent telephone call, through a pre-defined triage assessment provided by the respective Clinics. Will work collaboratively with Clinic Nursing Leadership to ensure patient requests and inquiries are managed timely and triage trigger words expeditiously. Will ensure payers are prepared to reimburse for scheduled services in accordance with the payer-provider contract and works diligently toward the identification, mitigation, and prevention of clinical denials. In addition to contacting payers and providers via phone, portal or fax, to secure authorizations, this position will use their clinical expertise by reviewing medical necessity, responding to authorization concerns and/or reconciling coverage-related issues Will assist the Pre-Service Team, primarily the Primary Care (adult and pediatric) PODS to t...