Health Plan Coordinator (Clinics)

Summary of Duties

Pay range: $22.64/hr. to $31.22/hr.

The Health Plan Coordinator is responsible for maintaining patient referral and authorization requirements as established by patient individual insurance plans. Is responsible for providing exceptional customer service, confirming patient health insurance coverage, and handling administrative tasks within a clinical setting. This role involves greeting patients, answering phones, scheduling appointments, updating and verifying insurance, and handling other office duties. The ideal candidate possesses strong organizational skills, attention to detail, and the ability to multitask in a fast-paced environment. Contributes to a positive work environment that promotes HMC values.

Essential Functions

Representative duties and responsibilities include, but are not limited to:

Insurance and Financial Management:

• Verification and updating of insurance, process referrals and authorizations as indicated by individual insurance plans, assists patients with co pay and drug assistance programs, monitor coverage limits for services as necessary, collecting payments, stay informed on insurance updates.

Medical Record Management:

• Obtaining medical records and authorizations, updating patient charts, and sending copies to relevant parties.

Telephone Triage and Communication:

• Answering phone calls, triaging patient needs, relaying messages, and responding to inquiries.

Administrative Tasks:

• Maintaining patient records, managing correspondence, processing insurance claims, opening clinic as needed, ordering supplies.

Patient Check-in and Check-out:

• Greeting patients, gathering information, scheduling appointments, and addressing patient concerns.

Hiring Competencies

Required Knowledge, Skills, and Abilities:

Knowledge of:

• Understanding of medical terminology, insurance authorization processes, healthcare and billing procedures and HIPAA regulations and confidentiality.
• Understanding of electronic Health Records and coding systems.

Skill in:

• Effective verbal and written communication, active listening and interpersonal skills.
• Time management, prioritization, attention to detail, and multitasking.
• Learning and becoming proficient in computer software, including EHR systems and scheduling software.
• Excellent customer service skills including patience, empathy and problem-solving.

Ability to:

• Learn and effectively use computer and software applications as needed to perform job duties.
• Maintain a professional appearance and demeanor.
• Learn and effectively use new technology/platforms in a timely manner.
• Work independently with moderate supervision.
• Collaborate effectively with healthcare team members.
• Adjust to changing priorities and work demands.

Additional Posting Information

Hillsboro Medical Center believes in providing equal employment opportunities for all qualified individuals. Recruitment, hiring, promotions, transfers, working conditions, training, and compensation will be based on qualifications without regard to race, color, sex, sexual orientation, gender identity, religion, age, creed, national origin, marital status, family relationship, veteran status, genetic information, physical or mental disability, or any other status or characteristic protected by applicable law. We further commit ourselves to continuing the practical application of this policy in our daily business conduct.