The Coordinator, Scheduling position is responsible for scheduling and coordinating off-site specialist appointments for urgent, routine and follow-up appointments in accordance with the approved authorizations, scheduling and turnaround time objectives. This position works closely with members of the IDT team to coordinate services and advocate for participants specialty needs. The Scheduling Coordinator advocates for participant's specialty needs, and is an integral part of the care team, working as a liaison between the participant, primary care physician (PCP), specialty providers and Utilization Management to ensure timely access to specialty care.
- Review approved authorization requests for accuracy. Communicate and coordinate with the Utilization Management department to modify authorizations, extend expiration dates, and modify CPT codes as
- Process ready-to-schedule authorizations per established guidelines and ensure that all urgent and routine appointments are scheduled within the CA Department of Managed Health Care Timely Access to Care guidelines.
- Collaborate with Primary Care Providers and nurses to ensure proper coordination of care regarding all specialty appointments.
- Document all interactions with specialty providers and participants in Epic.
- Document in Epic all barriers to timely scheduling of appointments. Communicate with participant's PCP of any delays in scheduling or barriers to care.
- Collaborate with Transportation Coordinator or center designee to schedule participant transportation for offsite medical specialty
- Collaborate with Care Center /Medical Escort supervisor for the coordination of escort coverage for offsite medical specialty appointments for participants that require support based on IDT approval.
- Perform appointment confirmation calls with the specialty offices and participants in accordance to confirmation call guidelines.
- Collaborate with Health Information team to obtain participant medical records as needed for upcoming offsite specialty medical appointments.
- Prepare and organize all medical notes, labs, radiology CDs, reports, required for specialty appointments; Release patient records to the specialty office via fax or Connect per protocol and HIM guidelines. Maintain communication with Primary Care Provider and Specialist regarding document requirements for all appointments. Collaborate with contracting team to escalate access to care issues related to contracted specialty providers.
- Collaborate with RN Case managers to coordinate specialty appointments for those participants receiving home health, chemotherapy, and dialysis.
- Communicate scheduled procedure requirements to licensed nurses prior to the specialty appointment for proper patient care (i.e. prep instructions, medication regimens, fasting, surgical procedures, etc.).
- Review and follow up appointment no-shows and cancellations that need to be rescheduled.
- Follow up with specialist office to request notes after appointment and follow the close the loop process.
- Reports any participant concerns or complaints immediately to supervisor.
- Manage the ready-to-schedule work-queue to avoid backlog and report errors to supervisor.
- Perform all other related duties as assigned.
- High School Diploma required.
- Medical Assistant Certificate required.
- Minimum of 3 years of experience working in medical or clinical field required.
- Experience working with referrals/authorizations and with an Electronic Health System is preferred.