JOB SUMMARY
The PrEP Care Coordinator will play a critical role in working closely with the clinical care team, testing and outreach manager and case managers in order to assist patients in obtaining timely, essential, and appropriate PrEP-related medical and social services to optimize health and prevent HIV acquisition. The PrEP Care Coordinator will consult with patients to answer questions about PrEP, administer risk assessment surveys, assist with medical insurance/benefits coverage, provide adherence counseling, conduct follow-up visits/phone calls, re-engage patients who have stopped, on shown noncompliance with program, follow-up via phone/text/email/social media, evaluate adverse effects, and liaison with clinical service providers to address specific health concerns. Other contributions will include assisting with the development, modification, and implementation of PrEP clinic protocols, reviewing patient charts, and entering/tracking patient data via the medical record program. The PrEP Care Coordinator will rotate among the participating clinics located within Lackawanna, Luzerne and Wayne Counties and within the community of the seven surrounding counties.
Required Skills
JOB DUTIES AND ESSENTIAL FUNCTIONS
- Communicate with patients, doctors, dental staff, clinic staff, and insurance providers regarding patient coverage on a daily basis
- Schedule patients for follow ups and/or labs
- Complete follow ups with patients who No Show for scheduled appointments
- Complete all insurance pre-authorizations and/or re-authorizations
- Complete patients enrollment into SPBP or medication assistance programs
- Assist with checking patient eligibility and benefits prior to their scheduled appointment with their insurance providers; i.e., Medicare, Medicare supplements, Medicare replacements, managed care, HMOs, PPOs, POS, OA, ACA
- Requests policy and coverage limits, deductible amounts
- Complete pre-authorizations and re- authorizations pertaining to medication assisted treatment medications
- Communicate and document the status of all procedure authorizations to the providers
- Verify authorization accuracy & track all patient authorizations
- Verify that each patient completes the program adherence form
- Complete patient monthly screenings
- Coordinate new referrals to the department
- Educate the community and staff on PrEP
- Conduct community based education events
- Other assigned office related tasks and duties as assigned
Required Experience
QUALIFICATIONS
- High school diploma or equivalent
- Previous front-office experience (2-4 years) in a high volume medical practice desirable
- Experience with MEDENT or other EHR software a plus
- Knowledge of medical terminology and insurances
- Proficiency in Word, Excel, PowerPoint and Email
- Must be reliable and punctual
- Ability to work with individuals from various ethnic, cultural and socio-economic backgrounds including the Lesbian, Gay, Bisexual, Transgender (LBGT) community in a culturally competent non-judgmental manner
- Ability to establish and maintain effective working relationships with a variety of clients who are living with HIV/AIDS in order to collect, verify, organize and analyze information to determine eligibility for health insurance coverage, medication assistance or premium assistance programs, and other public benefit programs
- A minimum of three (3) years recent hospital, health care clinic or community experience serving adults with HIV/AIDS or adults with complex medical, social and community living needs who require multiple community based supports and experience connecting them to appropriate care or benefit programs is required
- One year of experience working with people living with HIV, other chronic illness or ethnically, culturally, and sexually diverse population
- Must be able to perform effectively in a fast paced environment with many changing priorities
- Must be professional and customer service oriented to deliver quality excellent care
- Ability to work independently and with a team
- Professional written and verbal communication and interpersonal skills
- Willingness to work a flexible schedule
- Certified phlebotomist or interest in becoming certified preferred
- Ability to support patients with a wide variety of clinical and non-clinical needs
- Ability to work in a complex, multi-divisional environment with the skills to establish priorities, set objectives and achieve stated goals