PACE Central Michigan
Medical Records and Scheduling Specialist
What is a PACE program?
- The Program of All-Inclusive Care for the Elderly (PACE) is a unique health care model designed to help seniors (participants) stay safely in their home for as long as possible. PACE coordinates and provides or facilitates all medical care for its participants. Services are delivered across various settings, including on site at the PACE center, in the community, and in participant homes.
Why Work at PACE?
At PACE, employees have the opportunity to see the full impact of their efforts. Staffing ratios are much lower, time spent with each participant is much greater, and team collaboration occurs much more frequently than in other care settings. PACE is a very fulfilling health care delivery model for its employees.
Medical Records and Scheduling Specialist Responsibilities Include But Are Not Limited To:
- Responsible for maintaining all medical records within HIPAA standards and regulatory compliance, including organizing the storage, archiving, retrieval, and destruction of medical records.
- Obtains all necessary documentation from hospitals, providers, and other health entities as needed to ensure quality of care for participants across the continuum.
- Completes the scanning of documents in the EMR in a manner that ensures accessibility of medical information to the Interdisciplinary Team (IDT) members.
- Responsible for the documentation and release of medical records as requested. Ensures release of information is authorized prior to distribution of records to requesting party. Abides by all confidentiality requirements as they relate to the release of protected health information.
- Continuously monitors the Orders Tracking module within the EMR and schedules appointments as they become due.
- Schedules appointments for participants to see contracted medical specialists based on orders written by Primary Care Providers.
- Coordinates participant medical appointment schedules with Home Care visits, Adult Day Center attendance and Transportation availability.
- Creates and maintains the schedule for the on-site specialists including dental, vision, and podiatry.
- Completes the authorization process for appointments resulting in a claim.
- Communicates with participants/caregivers regarding specialty appointment details that include appointment and pick-up times, and any necessary updates/changes as they occur.
- Updates orders with progress and changes, resolves appointment conflicts, and adjusts the status of the order as warranted.
- Acquires, ensures completion of, and submits any required new patient forms and/or personal information needed for scheduling appointments.
- Cancels orders/authorizations when participants disenroll from the program.
- Actively participates in Quality Improvement (QI) processes, working closely with supervisor on chart audits; the development, implementation, and monitoring of Performance Improvement Projects; data collection for required quality reports; and other projects as requested.
- Performs routine auditing from admission through discharge as requested by supervisor.
- Communicates issues pertaining to the accuracy, content, and quality of the medical record with the appropriate staff and ensures corrective action is completed.
- Develops quarterly agenda, facilitates, and ensures follow-up for the Participant Advisory Committee.
- Maintains the database of participant utilization and inputs data regarding these services into the EMR.
- Investigates and resolves items placed on the weekly Pend Report from the TPA and submits results according to established timeframes.
- Facilitates the Orders Tracking Committee to discuss and resolve identified issues.
- Updates the IDT minutes with upcoming specialty appointments and the attendance status of those appointments.
- Attends morning IDT meetings to answer questions and provide input regarding the status of medical record documentation and participant appointments.
- Provides initial training to new hires and ongoing training to existing staff on QI Program as requested.
- Participates in required staff meetings and trainings.
Qualifications & Requirements:
- Associate or bachelor’s degree in related field preferred, or two years related experience
- At least 1 year of experience with aging services preferred
PACE Central Michigan is an equal opportunity employer and does not discriminate based on age, race, color, religion, sex, national origin, disability, or veteran status.