Patient Care Specialist III

Mosaic Health•Fort Myers, FL

About The Position

The Geriatric Patient Care Specialist serves as a vital link between our elderly patients, their families, and the multidisciplinary care team. This role is crucial for ensuring seamless patient navigation, comprehensive administrative support, and coordination of care services, ultimately contributing to the highest quality of patient outcomes. ‎ How will you make an impact & Requirements ‎ The Geriatric Patient Care Specialist serves as a vital link between our elderly patients, their families, and the multidisciplinary care team. This role is crucial for ensuring seamless patient navigation, comprehensive administrative support, and coordination of care services, ultimately contributing to the highest quality of patient outcomes.

Requirements

Experience: Previous experience in a healthcare administrative or patient care coordination role is preferred, especially in a geriatric or primary care setting.
Technical Skills: Proficiency with Electronic Health Record (EHR) systems (e.g., Athena) and scheduling platforms (e.g., Carelink).
Knowledge: Strong understanding of medical terminology, insurance verification, authorization processes, and common clinical workflows (e.g., lab orders, referrals, prescription refills).
Attributes: Exceptional organizational skills, attention to detail, strong verbal and written communication, and a compassionate, patient-centered approach.

Responsibilities

Patient and Care Coordination
Liaison/Communication: Act as the primary liaison, communicating regularly with patients, family members, and various providers and care teams (including specialists, PCPs, home health, and hospice agencies).
Appointment Management: Coordinate, schedule, and confirm new and existing patient appointments using systems like Athena and Carelink; place reminder calls to patients.
Case Management & Referrals: o Coordinate and schedule post-discharge visits for patients returning home from the hospital or skilled nursing facilities (SNF). o Monitor and manage the coordination of new patient referrals, specifically for house calls. o Process and track specialized referrals (e.g., specialists, home health, hospice, psychiatry), including faxing orders/referral packets and progress notes, and following up to confirm acceptance and scheduling.
Program Enrollment: Enroll eligible patients in Chronic Care Management (CCM), creating the necessary profiles and uploading consent forms; accurately document time spent on CCM tasks (e.g., home health orders, prescription management, phone calls).
GUIDE Program Management: Track referrals, discuss program details with patients, and set up in-person or telehealth visits, including confirming insurance and location details.
NP/Provider Support: Screen and return phone calls to family members on behalf of the Nurse Practitioner (NP).
Patient Registration & Data Entry: Perform patient registration, creating profiles in Athena, and accurately adding/verifying patient demographics, new patient insurance, and billing information. Upload admission packets as needed.
Census Management: Maintain and track provider census data, monitoring patient appointment cadence, referral status, and ensuring accurate provider and regional assignments in Athena and other tracking systems.
Insurance Verification & Authorization: o Verify patient insurance benefits. o Obtain necessary insurance authorizations for specialist referrals, CCM, Transitional Care Management (TCM) services, and medications.
Documentation: Document after-hours call notes in the patient chart.
General Administration: Assist with tasks related to practice capacity, general letters, and processing provider requests/orders.
Orders Processing (Lab, Radiology, DME): o Process lab and radiology orders, including faxing orders and demographics for mobile imaging. o Manage the Lab bucket by labeling/assigning reports and contacting patients to deliver lab results on behalf of the NP. o Complete and process Durable Medical Equipment (DME) orders, add addenda to progress notes, fax the order and face sheet to the vendor, and call to confirm receipt.
Medication Assistance: Verify medication dosage and frequency in the EHR and submit prescription refills on behalf of the NP. Send orders for acute issues to Assisted/Independent Living facilities (AL/IL) on behalf of the NP.
Medical Records: Send medical records requests on behalf of the NP; fax progress notes and records to specialists, PCPs, home health, and hospice agencies for care coordination.
Compliance: Track and manage death certificate requests. Send home health certifications to the Central Business Office (CBO). Serve as a liaison for unprocessed medical records requests between HealthMark and the patient/requestors.