In my previous role, I was responsible for coordinating care for patients within a managed care system, ensuring they received timely and appropriate services. I worked closely with healthcare providers, insurance companies, and patients to facilitate communication and resolve any issues that arose. My experience includes managing patient records, scheduling appointments, and verifying insurance coverage, all while maintaining compliance with healthcare regulations. This role honed my ability to multitask and prioritize in a fast-paced environment, ensuring efficient and effective patient care coordination.

When conflicts arise between patients and insurance providers, I act as a mediator to resolve the issue promptly and fairly. I listen to both parties to understand their perspectives and then work to find a solution that aligns with the patient's healthcare needs and the insurer's policies. My approach is to remain calm, professional, and empathetic, ensuring that the patient feels heard and supported throughout the process. I also document all interactions and resolutions to prevent future disputes and maintain clear communication channels between all involved parties.

Yes, I identified a bottleneck in our referral process where delays were causing patients to wait longer for specialist appointments. I proposed and implemented a digital tracking system that streamlined the referral workflow, reducing wait times by 30%. This system also improved communication between primary care providers and specialists, ensuring that all necessary patient information was shared efficiently. The success of this initiative was reflected in positive feedback from both patients and healthcare providers, and it demonstrated my ability to identify inefficiencies and implement practical solutions in managed care coordination.

To stay organized, I rely on a combination of digital tools and time-management techniques. I use electronic health records (EHR) systems to keep track of patient information and set reminders for follow-ups and appointments. Prioritizing tasks based on urgency and importance helps me manage my workload effectively. I also maintain a daily to-do list and allocate specific times for checking emails and returning calls. This structured approach ensures that I can handle multiple tasks efficiently without compromising the quality of care coordination or missing critical deadlines.

Ensuring compliance is a top priority in my role. I stay updated on current healthcare regulations by attending workshops and reviewing updates from regulatory bodies. I apply this knowledge by meticulously verifying that all patient interactions, documentation, and care plans adhere to legal and ethical standards. Regular audits of patient files and processes help identify any potential compliance issues early. Additionally, I collaborate with the legal and compliance teams to address any concerns and implement corrective actions when necessary, ensuring that our managed care coordination practices meet all regulatory requirements.