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Patient Care Specialist III @ Verawholehealth

North Fort Myers, Florida, USOnsiteFull-time
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About this role

Job Description Summary ‎ Support the clinical staff which includes scheduling, processing new patient referrals and cases, and work buckets.‎ How will you make an impact & Requirements ‎ 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.

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