The Patient Care Specialist provides case management support to patients with no insurance or commercial insurance who receive services in the primary care setting and performs the following responsibilities:
· Maintain the Referral for Testing/Procedures Referral Log
o Gather pertinent information from physicians, nurse practitioners and medical assistants to complete referrals/pre-certifications/prior authorizations
o Contact various offices/facilities to obtain necessary information to accurately complete referral requests.
o Prepare and process all referral paperwork, including pre-certification and prior authorization requests.
o Work with the patient to schedule the test/procedure and follow up to see the appointment has been completed and request results/documentation from the provider.
o Respond to patient inquiries regarding health plan referrals
· Maintain Patient Assistance Program enrollment and inventory.
o Assist patients in enrolling in Patient Assistance Programs for medications prescribed by their Medical Provider.
o Maintain inventory of Patient Assistance Program medications per patient, including log in/log out information.
· Complete call backs to patients regarding their lab results per directives of the Medical Services Provider.
· Assistant patients with no insurance who may be eligible for MoHealthnet Insurance in completing the application process per Presumptive Eligibility Protocols outlined by the MO-DHSS – Family Support Division.
· Monitor Preventative Services Tracking Chart in patient records to see services have been offered and/or provided to patients. Monitor Medical Provider’s daily schedule in an effort to remind Medical Providers a patient is in need of a particular preventative service
· Enter patient vitals and lab test results in to appropriate NextGen system fields
· Coordinate language interpreter services to patients as needed.
· Complete timely and accurate documentation of all support services provided to patients
· Will seek culturally competent services and service providers to meet the unique cultural needs of each patient and family member.
· Work closely with counterpart in the Behavioral Health Services Department and/or Community Support Workers, as applicable, regarding patients who receive outpatient psychiatric services and medical services
· Attend daily staffing with the Outpatient Services Team
· Maintain an accurate referral database
· Provide back up to Medical Assistants as needed (i.e. rooming patients, performing in-house lab tests, routine venipuncture, etc.)
· Assist with collection of specific patient data for annual UDS report
· Other duties as assigned
· L.P.N. and licensed under Chapter 335, RSMO, or Medical Assistant Certification with experience; equivalent experience considered
· Minimum two years medical office experience
· Social work and behavioral health knowledge experience
· Knowledge of Microsoft Office Suite
· Ability to maintain confidentiality
The Patient Care Specialist receives supervision from the Clinic Manager for that site.
Crider Health Center is a Community Health Center serving the mental, physical, and dental health needs of citizens of Franklin, Lincoln, St. Charles, and Warren Counties.
Join Our Team
We welcome inquiries from qualified individuals who want to be part of a team of hardworking, dedicated and compassionate employees whose work helps us aspire to our vision of full, healthy, productive lives for everyone. Crider Health Center welcomes all people regardless of race, age, gender, religion, education, nationality, ethnicity, family circumstance, marital status, veteran status, sexual orientation, gender identity and expression, and physical or mental ability.
Crider Health Center - 16 months ago
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