Patient Coordinator - Bariatric Center

Job Summary

Responsible for the coordination of care for patients who are seeking bariatric surgery. Coordinates, supports, and tracks the pre-operative plan of care for each patient, working collaboratively with other healthcare team members. Receives, processes, and documents referrals and prior authorization requests related to bariatric surgery. Provides customer service and support for the clinical areas and patients for referrals and prior authorizations (for both pre‑op visits and bariatric surgeries).

• Tracks and manages all patient movement through the program. Works closely in collaboration with the patient and care team to complete all necessary steps to receive surgery. Prioritizes patient program requirements to efficiently move the patient through the program, considering care team feedback and requirements and insurance needs.
• Screens patients’ eligibility for bariatric surgery program, including detailed evaluations of patient needs, review of medical criteria and insurance coverage. Oversees the data entry and completion of referral forms/notifications. Manages and receives patient records for abstracting from multiple healthcare communities; abstracts low to moderately complex clinical data using established definitions. Obtains insurance preauthorization for patients (and reauthorization of additional treatment when appropriate) for all pre‑operative visits.
  
  Ensures documentation requirements of insurance carriers are met and entered into electronic health record (EHR).
• Facilitates communication with physicians and other members of the healthcare team to assure seamless quality patient care/services across the care continuum. Serves as the primary point of contact for the bariatric team and patient regarding the patients’ progress in the program. Monitors and follows up on the pre‑operative plan of care. Efficiently manages correspondence with patients, providers, specialists, and insurance companies.
  
  Communicates with patients and other healthcare providers to obtain medical records and testing results required for surgery. Documents pertinent pre‑operative testing results in EHR. Facilitates weekly multidisciplinary team review to determine patient readiness for surgery. Ensures concise patient summaries are in place and a clear plan of care has been identified.
• Consults with new patients to review both program and insurance requirements for bariatric surgery, including estimated out‑of‑pocket expenses. Provides the patient with education materials for the bariatric surgery program and their process. Provides verbal and written notification of patient rights and responsibilities.
• Maintains and applies current knowledge of various insurance plans’ criteria for bariatric surgery and updates program materials accordingly. Works in collaboration with Patient Financial Services to improve the revenue cycle process.
• Oversees the data entry into patient coordination tool. Ensures proper tracking of patient progress through bariatric data base software to ensure compliance and maintenance of quality metrics in accordance with accreditation needs.
• Creates surgery preauthorization packet and remits to appropriate insurance carrier, ensuring preauthorization packet is complete with all documents required for authorization. Once insurance preauthorization for surgery is obtained, enters authorization number into EHR.
• Ensures consistent and appropriate communication with patients, physicians, specialists, and insurance companies in order to maintain quality care and promote patient satisfaction. Documents pertinent information in EHR.
• Serves as liaison between patients and care team. Coordinates the flow of patients through the bariatric surgery program, including pre‑surgical preparation. Coordinates and facilitates bariatric information sessions. Determines patients’ readiness for surgery based on surgical requirements, program requirements, and insurance company requirements. Facilitates the ordering of additional pre‑operative labs or testing as necessary.
• Manages schedules per region process.
• Maintains care coordination to ensure timely progression of patients…