Patient Care Specialist III

Essential Duties and Responsibilities include the following. Individual duties vary by market.  Other duties may be assigned.   

• 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.  This includes tracking referrals, new patient appointments, and monitoring census data to ensure all patients are seen on a regular cadence. 

• 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.   

• Coordinate care 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.