Patient Care Manager

Duties: Ensure that the patient moves through Barbour Orthopaedics & Spine patient process efficiently and to their natural conclusion. Patient Scheduling: Managing new patient referrals and overseeing timely and efficient scheduling. This will include working with the SDR and CSR to ensure:New referrals are called within 1 hour of receipt.Proper triage of past medical history and gathering of pertinent records for initial appointment.Referral sources are updated on the status of patients being scheduled.AE's and referral sources are notified when patients are unresponsive or cancelno-show multiple times. Billing and Documentation: By following up with referral sources no later than 72 hours after each patient appointment with updated notes. The goal is to minimize unnecessary visits: Prevent no-shows andor cancellations by keeping the referral source up to date. Ensure all treatment recommendations have been properly coordinated and completed. Make sure outside reports are collected and uploaded for clinic to review.Patient questions or concerns are addressed fully Referral Monitoring:Communicating with referral sources to obtain relevant case information which will allow us to maximize treatment for patients treating on a lien basis.Overseeing prompt response time for full and final requests that are sent to AR Team for follow up and involving supervisor when necessary.Works with the clinical team and referral sources to develop alternative treatment options if patient cannot follow through with existing recommendations for one reason or another.Referral Source Development:Partner with AE's and PM's to keep detailed and accessible records of referral source preferences, transactions, comments, and complaints. Actively develop plans for "Bronze" or 'low Silver" referral sources to achieve "Gold" or top referral source status.Working with Practice Managers and Account Executives to identify trends for specific locations' referral sources as well as troubleshoot issues and problems that arise in a timely and efficient manner.Responding promptly to referral source inquiriescomplaints and ensuring follow through from appropriate party, which could include various department supervisors, an AE, SDR, CSR, ACD, or PM.Record Management:Overseeing prompt response time for medical records requests that are sent to the Medical Records Team for processing and involving supervisor when necessary.Working with referral sources to maximize treatment based on available case limits and review of police reports, property damage photos, case details, declarations pages, and existing financials. Case Manager will also be prepared to provide alternative funding recommendations in situations where an in-house lien option may not be available.Partners with billing team and clinical team to process various pre-paid requests such as medical questionnaires, medical narratives, and requests for PPD ratings.Oversees timely and accurate follow up from clinic in instances where correctionsaddendums are needed for existing medical notes.Generate formal treatment estimates when requested by referral sources.Reporting Weekly Metrics to PM, AE, and CSR Supervisor for:New Patient Referrals - Total volume, how many scheduled, how many still pending and why, outstanding referrals from previous weeks, and any issues that arose in the previous week concerning new patient jections - Total volume, how many ordered last week and how many were live orders v. recommendation only. Of the live orders, how many scheduled vs. pending. How many outstanding injections are there from previous weeks and were there any issues that arose in the previous week concerning injection scheduling.Surgeries - Total volume, how many surgeries were ordered the previous week. How many were live orders vs. recommendation only. Of the live orders, how many were scheduled or are in the process of being scheduled vs. how many were denied. How many awaiting answers and is an AE currently being deployed to assist. Will also partner with MCC team and CSR to ensure patient is attending appointments with our office and clearance appointments as indicated.Utilization of other skill sets (e.g. speak a foreign language, mastery of Microsoft office) maybe required.And any other responsibilities assigned by your manager.Job Requirements:Degree not required.At least 2 years medical or legal case management experience.World class knowledge of Salesforce and Microsoft Office 365Ability to effectively deliver clear, concise communication.Ability to excel as a team player on a daily basis and foster positive relationships interdepartmentally.Bilingual preferred.Strong planning and organizational skills and ability to be a self-starter.Able to work under pressure with competing demands requiring ability to effectively organize and prioritize workload and time.

Created: 2025-03-03