About Lucent Health Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers. Company Culture We believe that the success of Lucent Health relies on having employees who are honest, ethical and hardworking. These values are the foundation of Lucent Health. Honest
- Transparent Communication: be open and clear in all interactions without withholding crucial information
- Integrity: ensure accuracy in reporting, work outputs and any tasks assigned
- Truthfulness: provide honest feedback and report any issues or challenges as they arise
- Trustworthiness: build and maintain trust by consistently demonstrating reliable behavior
Ethical
- Fair Decision Making: ensure all actions and decisions respect company policies and values
- Accountability: own up to mistakes and take responsibility for rectifying them
- Respect: treat colleagues, clients and partners with fairness and dignity
- Confidentiality: safeguard sensitive information and avoid conflicts of interest
Hardworking
- Consistency: meet or exceed deadlines, maintaining high productivity levels
- Proactiveness: take initiative to tackle challenges without waiting to be asked
- Willingness: voluntarily offer to assist in additional projects or tasks when needed
- Adaptability: work efficiently under pressure or in changing environments
Summary The Billing Care Coordinator is a key part of the Concierge Team based in the Narus Patient Support Center in Nashville, Tennessee. The Billing Care Coordinator, as a part of the multidisciplinary care team, is responsible for compassionately helping patients with the insurance and billing complexities that arise when diagnosed with complex illnesses, recovering from a traumatic clinical event, and/or providing general member support. This role administratively supports the multidisciplinary team as they develop and manage a comprehensive, individualized care plan for each patient. The role assists in self-funded insurance navigation of benefits, billing related issues, claims inquiries, general customer service assistance and address non- clinical issues that impact quality of life and outcomes. Responsibilities: The Billing Care Coordinator supports the multidisciplinary care team by ensuring seamless delivery of the Narus program for individuals and their families by providing the following services:
- Providing an excellent member experience through direct communication through high volume inbound and outbound calls and secure messages.
- General care coordination duties including:
- Assist Member w/ locating plan friendly providers or facilities.
- Assist in preventing and/or resolving delay in care by educating providers/facilities on RBP insurance.
- Confirm the deployment and receipt of ancillary services such as home health, DME, radiology, and community based social services.
- Aid and resolve patient issues regarding claims, billing, and payment of healthcare services.
- Educate members on benefits plans including items such as: deductibles, in/out of network inquiries, and estimation of benefits (EOB's), and plan types.
- Perform appropriate triage and escalation of routine and urgent patient calls to the clinical team when appropriate.
- Calls external facilities and providers to execute on care plan issues for patients.
- Make outbound patient calls to coordinate non-clinical patient needs.
- Assist care team with locating community resources for our patients.
- Assist office-based team with faxing, documentation, and telephonic/virtual support of care management priorities.
- Participate in weekly team meetings, and bi-weekly one-on-ones.
Qualifications: A minimum of two (2) years of related experience or equivalent, preferably in a physician office or clinical call center.
- High school diploma required.
- Patient, compassionate, and professional personality with strong service orientation.
- Proficient on Microsoft Office programs, EMR/Care Management platforms, and keyboarding.
- Demonstrated knowledge of legal and ethical issues related to confidentiality, including HIPAA and state specific privacy laws.
- Knowledge of Reference-based pricing (RBP) and understanding the relationship between self-funded insurances and third-party administrators preferred.
- Ability to analyze complex data, draw conclusions, and act on that information in a timely manner.
- Ability to apply problem-solving techniques to the case management process.
- Excellent time management, flexibility, organizational, and multi-tasking skills with the ability to work independently.
- Critical thinking and good judgement to quickly determine and prioritize issues
- Good communication, teamwork, and interpersonal skills with the ability to work with all levels of management.
- Prior telephonic patient engagement or care coordination experience required.
- Previous experience in medical claims and billing preferred.
Equal Employment Opportunity Policy Statement Lucent Health is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, color, creed, religion, alienage or national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity, gender expression, transgender status, sexual orientation, marital status, military service and veteran status.