Clinical Care Coordinator

• Review physician orders for surgical procedures, diagnostic tests, therapy sessions, or clinical services
• Validate and match orders against CPT/HCPCS codes and ICD-10 diagnoses before submission
• Initiate, track, and secure insurance prior authorizations based on CPT codes and clinical necessity guidelines
• Answer inbound and place outbound calls to insurance companies, medical providers, and patients
• Resolve authorization inquiries, verify coverage rules, and address peer-to-peer or appeal requirements
• Schedule surgical procedures, pre-operative testing, and clinical follow-ups after authorization approval
• Coordinate surgery times, facility block times, and physician calendars
• Guide patients through pre-procedure instructions, required medical clearances, and appointment logistics
• Maintain authorization and scheduling records in the practice EHR/EMR system
• Monitor pending orders to prevent delays between physician order placement and final patient scheduling

Clinical Care Coordinator jobs in Philippines

Surgical & Clinical Care Coordinator – CPT & Authorization Specialist