Accountability Chart Key Roles

• Schedules participant appointments.
• Works with external vendors to ensure proper authorization of appointments.
• Collaborates to ensure participant transportation.

Duties and Responsibilities

• Schedules internal clinic appointments, assigns tasks to appropriate task lists.
• Receives outside medical referral authorization and processes.
• Utilizes basic coding and medical terminology to interpret authorization needs.
• Assures proper authorization under PACE guidelines.
• Processes and prioritizes referrals utilizing basic diagnosis knowledge.
• Monitor open referrals or those pending in the order tracking system to assure continuity of care.
• Communicate
  • With patient and referral sources via telephone, mail, email and remote technology of scheduled appointments, delays or changes well in advance of the scheduled appointment date.
  • With the specialty office to obtain and provide all pertinent information involved in the referral process.
  • With specialty providers and internal and external staff to assist in resolving pending, denied and other problematic referrals.
  • With the Interdisciplinary Team any issues regarding referrals or prior authorizations
• Collaborates to ensure clinic regulatory compliance by ensuring initial and semiannual/annual assessments are scheduled prior to care plan per location and as coverage is needed.
• Works with HIM and other departments to ensure completion of appointment cycle.
• Prepares and ensures delivery of paperwork required by outside providers for authorized referrals.
• Coordinates appointments with other departments as needed.
• Coordinate and schedule internal specialty clinics (Example: Optometry, Dental etc.)
• Provides excellent customer service to all external and internal service providers.
• Must complete all required education and file requirements on time.
• Documents in the participant’s medical record as required by policy.
• Must care, support, and collaborate with everyone involved in the participant’s care including staff and the participant’s family using the participant centered care model.
• Keeps the leader informed of problems or issues.
• Performs other duties as assigned.

Qualifications

• Must possess, as a minimum, a high school diploma, or equivalent
• Associate degree preferred.
• One year of experience in a medical scheduling role preferred.
• Completed a medical terminology, CPT, ICD-9 coding course, or willing to take basic coding and terminology education within one year of employment.
• Must have excellent computer skills (i.e. Microsoft Office, Medic).
• Must have excellent verbal and written communication skills.
• Ability to maintain positive customer service.
• Ability to establish effective working relations with office staff and employees in a team environment.
• Must maintain the highest level of confidentiality.
• Effective prioritization skills and ability to manage time independently.
• Critical thinking skills, ability to multi-task and effective problem solving.

• Demonstrates our core values of compassion, integrity, teamwork, and excellence.
• Support of Senior Care Partners P.A.C.E. philosophy.
• Must provide exceptional customer service in support of all staff, external partners, and participants.
• Must possess the ability to make independent decisions when circumstances warrant such action.
• Must possess the ability to plan, organize, develop, implement, and interpret Senior Care Partners.
• P.A.C.E. goals, objectives, policies, and procedures.
• Must be able to maintain confidentiality regarding sensitive and private information.

• Has a visible presence while working in the center and is subject to frequent interruptions.
• Communicates with staff, participants, caregivers, and other organizations, as necessary.
• Works beyond normal working hours and on weekends and holidays, as necessary.

• May be subject to exposure and handling of infectious waste, diseases, conditions, or hazardous chemicals, etc., including potential exposure to TB, AIDS, and/or Hepatitis B virus.
• Subject to callback during emergency conditions (e.g., severe weather, evacuation, disaster, etc.).
• Required to drive a car in all types of weather.

• Must be able to cope with the mental and emotional stress of the position.
• Must function independently, and have flexibility, personal integrity, and the ability to work effectively with participants, staff, and support agencies.
• Must be able to push, pull, move, sit or stand for long periods of time.
• Lift up to twenty pounds as needed.

• Must have reliable transportation, current valid Michigan driver’s license and car insurance.
• Must be 18 years of age or older.
• Must be fully vaccinated, or willing to be fully vaccinated against the following communicable diseases: Influenza, MMR, Varicella, Tdap/Td, Covid-19 and Hepatitis B.