Patient Access Coordinator

About the role

The Patient Access Coordinator is an essential member of the outpatient program that focuses on an open access model. The Patient Access Coordinator is responsible for conducting critical processes related to referrals, intakes, and client services. The Patient Access Coordinator will be responsible for processing incoming external, internal, and self-referrals. The Patient Access Coordinator will work closely with the Directors at the Outpatient clinic, and Residential Directors and external providers to ensure incoming patients meet eligibility criteria. This process includes quality assurance tasks such as following up with patients who did not keep their appointment, referral/application data entry, reviewing documents to ensure all necessary information is obtained and uploaded, checking insurance eligibility, and communicating with the referral source.

Following Casa Esperanza’s integrated care model, the Patient Access coordinator will communicate admissions information and complete referrals to other Casa Esperanza services the client may qualify for. All documentation will be stored in Evolv, our Electronic Health Record and billing database. This position will work and report directly to the Director of Patient Access.

Essential Functions & Responsibilities:

Intake Responsibilities:

• Build and maintain relationships with internal and external referral sources
• Maintain awareness of current census and caseload targets and expectations
• Ensure timely access to clinic services and work with clinical team to remove barriers to care
• Oversee initial assessment, and follow-up care with internal and external providers to ensure timely access to services and operations for a dynamic, open access, integrated care clinic, including ASAM, Biopsychosocial and Urgent Care Triage as needed
• Identify individuals in crisis and engage clinical team for crisis response
• Manage communication and coordination amongst internal and external providers to ensure timely access to care, including the prioritization of high-risk/high-need clients
• Maintain and update any admission documentation required by Casa Esperanza or licensing agencies in a complete and accurate manner
• Serve as a resource for problem resolving issues related to registration, demographic, and insurance errors. Verify insurance eligibility and enter benefit assignment
• Adhere to all HIPAA and 42CRF laws following all confidentiality and protected health information regulations
• Ensure data entry and scanning of all referrals, intake and other pertinent documentation into Evolv.
• Implement BSAS and Medicare regulation and process
• Ensure completion of Integrated BPS in patient’s electronic health record
• Review client records for completeness of client insurance information and proper signature
• Other duties as assigned

Clinic Operations

• Work closely with the Patient Support Services to ensure an exceptional level of service is delivered to all Casa Esperanza clients
• Work closely with the Directors at the Outpatient Services, Director of Recovery Support Services and Residential Program, Conexiones and ATS Program to ensure that meet all licensing, regulatory, and accreditation, and funder standards and requirements
• Coordinate to ensure room utilization system that will effectively support the growing need of the clinic
• Respond to internal and external data collection and reporting requests
• Other duties as assigned

Qualifications:

• Bachelor's degree in social work, psychology, counseling, or related field required.
• LADAC/CADAC requirement or willing to obtain within 6 months on the job
• English/Spanish bilingual required
• Knowledge in Eligibility Verification and Authorizations based on payer requirements
• Experience working with marginalized communities
• Strong verbal/written communication
• Ability to work as both an effective team member and independently
• Ability to meet the physical requirements and training requirements of the position
• MassHealth Certified