Dean's Professional Services is now hiring a qualified, patient-care-focused Program Coordinator to work for a Hospital Facility in the San Antonio, Texas area. Remote We are on a mission to create care that's more convenient and professional. With solutions that are value-based and patient-centered. To accomplish this, we are looking for individuals who share our sense of excellence and are ready to embrace new opportunities!
A Program Coordinator is responsible for assisting activities related to the medical and psychosocial aspects of utilization and coordinated care.
Job Responsibilities: Processing of authorizations and follow-ups for DME, MHM, DAHS, and reductions/denials in which we are now at a 1 BD TAT for the processing of SK/SH/MMP authorizations. We utilize project temps/contingent workers to assist with each of these areas as well as cross train them to be able to assist in multiple functions. The team continues to experience high authorization volumes. Initiate authorization requests for output or input services in keeping with the prior authorization list. Research claims inquiry specific to the department and responsibility. Perform tasks necessary to promote member compliance such as verifying appointments, obtaining lab results. Assess and monitor inpatient census. Screen for eligibility and benefits. Identify members without a PCP and refer to Member Services. Screen members by priority for case management (CM) assessment. Perform transition of care duties to include but not limited to, contact the member's attending physician, member or medical power of attorney, other medical providers (home health agencies, equipment vendors) for information pertaining to special needs. Coordinate services with community-based organizations. Attend marketing and outreach meetings as directed to represent the plan. Produces and mails routine CM letters and program educational material. Data enter assessments and authorizations into the system. Complete assigned tasks and document findings Follow up calls with DME companies, Physician's offices, etc. Coordination with multi-disciplinary teams Follow up calls to members. Any other projects that may arise Job Requirements: High school diploma or equivalent. Required 2-3 years managed care setting, medical office or facility setting with demonstration of medical administration duties.– Required 2+ years of experience in a managed care environment or working with people who have disabilities and/or with vulnerable populations who have chronic or complex conditions. –Required Thorough knowledge of customer service, utilization review or claims processing practices in a managed care environment and operation of office equipment such as a personal computer. - Required Knowledge of medical terminology. – Required Medical Assistant background – Required Clinical setting experience such as hospital, MD office, etc. – Required Microsoft Outlook, Microsoft Teams, Zoom, Microsoft Word, Microsoft Excel, SharePoint, Internet– Required Job Details: M-F 8am – 5pm $18/hr + benefits Full benefits – healthcare, dental, vision, 401k program. Temp-to-Hire opportunity. Outpatient facility Dean's Professional Services is a national, award-winning staffing solutions firm. Since 1993, DPS has placed over 45,000 professionals across the nation. We work with our clients to provide placement opportunities that match your skill, experience, and personality. For more information please visit .
