Patient Care Specialist III

How Will You Make An Impact

• Enter new patient insurance and billing info to verify insurance benefits.
• Insurance authorizations for specialist referrals and chronic care management - call insurance to obtain authorization for transition of care visits.
• Monitor and coordinate new patient referrals for house calls.
• Patient registration, create Athena profile for new pts, add and verify insurance and demographic information.
• Enroll in chronic care management and create CCM profile and upload consents for patients.
• Document after hours call notes in chart.
• Schedule coordination with patient appointments.
• Call patients to schedule visits and call for appointment reminders.
• Track provider census data with tracking system.
• Maintain census data in Athena including correct House calls provider and region.
• Schedule coordination with APs using CareLink.
• This includes scheduling patient in with other patients in close proximity based on zip codes.
• Rescheduling appointments due to high needs TCMs, stat referrals and provider conflicts.
• Guide program - tracking referrals, calling patients to discuss program, set up in person visits/telehealth visits.
• Also confirming insurance and location.
• Case management assistance - coordinate and schedule visits for patients who discharge from the SNF or hospital.
• Care coordination with visits for AL/IL patients.
• Triage and return patient messages.
• Upload admission packets, insurance documents to Athena.
• Pull hospital and medical records for TCM visits.
• Enter time spent in CCM - for tasks such as home health orders, prescription refills/management, phone calls, etc.
• Liaison between patient, care teams and provider - communicate with the patients/family members as needed for providers.
• Assist with capacity, documents and General letters.

Requirements

• Knowledge of electronic health record systems (EHR).
• Strong communication skills, both verbal and written.
• Ability to manage multiple tasks simultaneously.
• Proficient in Microsoft Office Suite.
• Basic understanding of insurance claims and coding.
• Experience with scheduling software and databases.