Job Description

Compensation: 16.37/hr

POSITION PURPOSE

The Patient Care Specialist is part of the person-centered integrated care team and provides case management support to patients with no insurance or commercial insurance who receive services in the primary care setting.

ESSENTIAL FUNCTIONS – JOB SPECIFIC

• Maintain the Referral for Testing/Procedures/Referral List
o Gather pertinent information from physicians, nurse practitioners, nurses, 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
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
o Maintain Patient Assistance Program enrollment and inventory
• Complete call backs to patients regarding their test results per directives of the Medical Services Provider
• Complete timely and accurate documentation of all support services provided to patients
• See culturally competent services and service providers to meet the unique cultural needs of each patient and family member
• Collaborate with Behavioral Health Services Department and/or Community Support Workers, as applicable
• Maintain an accurate referral database
• Assist with collection of specific patient data for annual Uniform Data System (UDS) report
• Attend all trainings and/or staff meetings as required by Compass Health
• Complete Medication and Durable Medical Equipment (DME) prior authorization and documentation as needed
• Obtaining results from referrals, diagnostics, and other documentation from outside providers and entering in Electronic Health Record charting appropriately
• Assist with information related to community resources specific to patient needs outside of the standard Primary Care
• Other duties as assigned

ESSENTIAL FUNCTIONS/CORE COMPETENCIES – COMPANY WIDE

• Regularly attends work except for approved absences
• Attends all training as required
• Maintain professional, “champion” behavior
• Provides quality customer service
• Provides services with a commitment to service excellence
• Works in a way that exhibits a commitment to personal excellence
• Team oriented and values diversity

DESIRED DEMONSTRATED KEY COMPETENCIES

• Change Readiness
• Collaborative Relationships
• Conflict Resolution
• Communication – Oral
• Communication – Written
• Forward Thinking
• Multitasking/Planning
• Organizational/Time Management
• Teamwork