Analysis Skills, Auditing, Behavioral Health, CPR Certification, Co-Payments, Communication Skills, Community and Social Services, Compensation and Benefits, Computer Operations, Detail Oriented, Diversity, Driver's License, Electronic Medical Records, Establish Priorities, First Aid, HIPAA (Health Insurance Portability and Accountability Act), Healthcare, Human Health, Information Technology & Information Systems, Insurance, Keyboards, Liability Insurance, Maintain Compliance, Medical Terminology, Microsoft Windows Operating System, Organizational Skills, Outpatient Care, Patient Care, Presentation/Verbal Skills, Problem Solving Skills, Process Improvement, Project/Program Management, Psychiatry and Mental Health, Quality Assurance, Quality Management, Regulations, Substance Abuse, Time Management, Training/Teaching, Vehicle Driving, Word Processing, Writing Skills
Statement of Purpose
The Lead Care Coordinator, under the direction of the Program Manager, oversees the referral intake process and supports seamless patient flow. The role works closely with patients, staff, and external partners to ensure comprehensive, non-judgmental care, and assists in training new and existing team members. Demonstrating the core values of Behavioral Health Services, Inc., the Lead Care Coordinator provides referral intake, scheduling, patient management, benefits verification, insurance navigation, client advocacy, and coordination of substance use disorder referrals across health clinics, residential programs, and outpatient facilities.
Major Tasks, Duties and Responsibilities
- Assists in the supervision of work and performance of the care coordinators and other support staff as instructed.
- Responsible for training new hires
- Assisting management with audits for compliance.
- Assisting management with re-distribution of workloads when needed.
- Representing the staff to contribute input based on proposed changes to policy, workflow, and systems that would impact your team.
- Identify the staff to contribute based on proposed changes to policy, workflow, and systems that would impact your team.
- Identify and reporting any problematic issues related to the duties of your team.
- Assisting in process improvement and quality assurance projects related to your team's responsibilities.
- Works collaboratively with program manager, care coordinators, and support staff to maintain an effective workflow in the ICS department.
- Verifies and confirm insurance coverage using diagnostic and procedural codes.
- Provide a centralized contact point between BHS service providers, insurance companies and patients.
- Demonstrate excellent written and verbal communication skills; be familiar with insurance terminology, policy types and industry guidelines.
- Reviews patient's case and insurance coverage to determine co-pays or other insurance requirements.
- Advocate for patients with providers.
- Respond to treatment team and patient inquiries by phone and email.
- Maintain strictest confidentiality; adhere to all HIPAA guidelines/regulations.
- Knowledge of drug and alcohol dependency, mental health, family and systems.
- Demonstrate ethical and professional behavior.
- Conveys respect for cultural and lifestyle diversity of clients and staff.
- Basic knowledge of referrals, both inside and outside of the BHS treatment system.
- Basic understanding of computer operations; Windows and word processing. Ability to readily adapt to the indicated automated information system.
- Other duties as assigned.
Care Coordinator Competencies and Performance Expectations:
- Verify insurance benefits
- Register, conduct intakes, and schedule patients into EMR system
- Ability to Communicate clearly and advocate patient care needs with insurance companies, health clinics, residential and outpatient facilities and BHS staff
- Excellent organizational skills and attention to detail
- Excellent time management skills with the ability to meet deadlines
- Strong analytical and problem-solving skills
- Ability to prioritize tasks and to delegate them when appropriate
- Ability to function well in a fast-paced and at times stressful environment
- Adhere to professional standards
Prerequisite Qualifications
Following are the qualifications required to perform the essential functions of this position. Qualifications may be subject to modification based on the Americans with Disabilities Act.
Bilingual abilities may be required within certain BHS programs.
Bachelor's Degree in a in health or human/social service or related field related field. Certification as a chemical dependency counselor. Minimum of five years working in substance abuse. Knowledgeable of insurance benefits and medical terminology.
Must have valid California driver's license and liability insurance if driving personal vehicle on BHS business.
Vision, hearing, manual dexterity and eye-hand coordination must be adequate for performance of job duties. Able to sit at desk, use keyboard, write and physically perform other job duties. Able to move about the facility.
Specific qualifications may vary based on assignment. The supervisor will initial those items on the following list, which apply and write N/A to indicate those qualifications, which are not applicable:
_____ Class "C" California Driver's License.
_____ Personal vehicle with liability insurance for reimbursable mileage, generally short distances.
_____ First Aid certification, obtain within 90 days of employment and maintain current thereafter.
_____ CPR certification, obtain within 90 days of employment and maintain current
thereafter.
_ Bi-lingual (specify: ___)
The above statements reflect the general duties considered necessary to describe the principal functions of the job as identified and shall not be considered as a detailed description of all the work requirements which may be inherent in the position.