External Scheduler

AcuteCare Health System LLC•Lakehurst, NJ

About The Position

The External Scheduler is responsible for coordinating and maintaining participant schedules for services authorized by the program and related schedules to ensure seamless service delivery within the PACE organization. This role involves creating efficient schedules, managing changes, and communicating updates to all relevant parties. The External Scheduler works closely with interdisciplinary teams (IDT) to ensure timely service delivery, optimize resources, and support high-quality care for participants. Accuracy, organization, and effective communication are key to success in this position.

Requirements

High school diploma or equivalent (required).
1–3 years of experience in health care administration – referrals, claims, order management, scheduling, administrative support, or healthcare operations (required).
Must have reliable transportation, a valid driver's license, and the minimum state required liability auto insurance.
Be medically cleared for communicable diseases and have all immunizations up to date before engaging in direct participant contact.
Employment with BoldAge PACE is contingent upon successful completion of post-offer pre-employment screening and verification processes

Nice To Haves

Knowledge of provider network management, payer requirements medical documentation(preferred)
Familiarity with scheduling software and electronic health records (EHR) systems (preferred).
Experience in a healthcare or PACE-related setting (preferred).
1 year of experience working with a frail or elderly population preferred. If this is not present, training will be provided upon hiring (If applicable for the role).

Responsibilities

Daily intake and review of new referrals/orders and take action to complete the authorization and scheduling for assigned referrals/orders. Assignments are defined by manager for specific roles, with Scheduler typically assigned orders/referrals to external providers.
Manage scheduling for participants for any related visits or services to meet both compliance requirements and ensure efficiency & accuracy to support participant satisfaction
Utilize systems and/or research to identify to deliver ordered services and initiate Single Case Agreements (SCA) or Out of Network (OON) request, when applicable.
All visits scheduled visits must be documented as completed, cancelled rescheduled daily
Use the transportation system or related systems to confirm completed appointments
Coordinate participant appointments, identifying he need for transportation for visits across various care settings, including clinics, home care, and community locations.
Contact providers / access External EMR/EHRs for medical records& for scheduling
For disenrollment's, produce output of medical records and send to receiving provider(s)per IDT instructions
Communicate schedule updates and changes promptly to participants, caregivers, and staff
Address scheduling conflicts and resolving issues in a timely manner and must document within the system (e.g. Use of Comments)
Collaborate with interdisciplinary team members to prioritize and address urgent scheduling needs.
Maintain and update scheduling systems, ensuring accurate documentation and compliance with organizational standards.
Monitor rejected claims and/or authorizations reports or systems to identify issues and research to resolve issues in a timely manner
Monitor and adjust schedules to optimize resource utilization minimize disruptions.
Participate in audits conducted by internal or external entities to audit and review participant records & related documentation and/or conduct peer review of work product for quality assurance purposes
Track and follow specific scheduling metrics to meet requirements for provision of services
Continuous improvement of process; identify areas for improvement and assist with implementing solutions and improvements
Assist with special projects or other duties assigned to support operational goals.
Engage in supporting and promoting Quality Initiatives.
Follow all policies related to company ethics to maintain security and confidentiality for all company assets, property, and all information about participants, clients their families
Maintain a safe working environment. Follow Safety Policies and Procedures.
Participate in any required staff and training meetings
Perform other duties as required or requested