It is the responsibility of the Managed Care Coordinator to coordinate and facilitate patients through their Health Care Treatment.  He/She will obtain certification and authorization to treat patients; plus provide coverage and support to the Satellite facilities.

Responsibilities include, but are not limited to:

• Verity patient eligibility and benefits for patients who have selected an Ambulatory Care Center Physician as their Primary Care Physician (PCP) and for patients referred by an outside PCP to an Ambulatory Care Center specialist. 
• Complete referral forms for patients referred by the PCP to specialists and for patients seen by specialist who required additional services.    
• Review Medical Records to determine number of referrals used and remaining.  Obtain referrals or pre-authorization for additional visits, diagnostic and other procedures requested by the Ambulatory Care Center PCP or specialist.  Enter information into Meditech system.    
• Work with the Admitting Department to obtain pre-authorization for elective admissions, Ambulatory Surgery and other outpatient procedures requested by the PCP. 
• Prepare a daily log noting patient name, managed care plan, procedure, referral or pre-authorization number and forward to the Physician Billing Department.
• Act as liaison for PCP, specialist, patient and insurance carrier to educate all parties involved and ensure proper protocol is followed.
• Participate in managed care meetings and committees formed by the managed Care Department and A.C.C.
• Open and review mail addressed to Ambulatory Care Center PCP’s and distribute to the appropriate departments.

Minimum of 3 years experience in a Managed Care environment.  Knowledge of medical terminology and codes.  Must be computer literate.

EDUCATION:

High School Diploma, Degree in a Business related field preferred.

CONTACT: Human Resources Department                  

                    Telephone: (718) 869-7650 

                    Fax Resume to: 718-869-5407

Equal Employment Opportunity