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WC
Wood County Hospital Assn
Patient Benefit Coordinator / Full Time / Days
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What they do
A Clinical Coordinator coordinates operations and oversees medical assisting staff in a clinic or medical department. Responsibilities include supervision of day-to-day operations, management of business aspects, HR duties within the team.
$69,493 / year median in Ohio
+14% projected growth
Job Description
Elevate your career at Wood County Hospital, where you're not just a number - you're a vital part of a team making a real difference. Patient Benefit Coordinator / Full Time / Days The Coordinator, Patient Benefits is responsible for verifying insurance coverage, securing required authorizations and precertification, documenting and communicating benefit information, and coordinating with patients, providers, and payers to ensure accurate reimbursement, regulatory compliance, and seamless revenue cycle operations. The Coordinator, Patient Benefits is an onsite position. Essential Functions Verify insurance eligibility and registration accuracy by o btaining registration and scheduling documentation from ancillary departments and surgery; verify and correct insurance information; and contact physician offices to secure updated coverage details as needed. Secure precertification and authorizations through i nitiating contact with insurance companies and third-party payers to obtain required precertification; gather and submit supporting clinical documentation; coordinate with utilization review staff; and enter admissions into MCG when applicable. Document and communicate benefit information by recording detailed benefit verification information—including deductibles, coinsurance, exclusions, referral requirements, and limitations—in account notes and verification forms; and professionally communicate coverage details to physicians, staff, and patients. Manage denials and appeals by initiating and monitoring precertification appeals within required timeframes; follow up with payers for status updates; and submit additional documentation to support medical necessity and authorization approval. Perform revenue cycle operations and regulatory compliance activities, including financial services projects, reporting, system updates, medical record requests, and ongoing monitoring of insurance and government regulatory requirements impacting benefits and prior authorization. Prepare, prevent, protect and respond to support our culture of safety. Works hours per week in accordance with offer letter or per attributes of position at transfer request. May be expected to work longer hours as necessary. Other duties as assigned.