PACE Referrals Specialist

Job description

Position Summary: Responsible for timely processing, documenting, and follow up of referrals and request for treatment authorizations as requested by the primary physician and contracted network providers/vendors. Essential Functions of the Job: - Receives and processes referrals and approvals in alignment with the minimum expectations of CMS. - In an expeditious manner, reviews existing PACE network of providers, coordinates and schedules specialty appointments as needed. - Obtains approvals from providers and disseminates information to participants in writing or electronic media. - Coordinates care within the guidelines of multiple providers. - Responds to inquiries as to status of authorizations by assessing the request and evaluating the circumstances to provide the correct information. - Initiates the appropriate documentation of requests from specialties offices for ongoing care. - Follows-up on missing documentation on submitted authorization requests to obtain sufficient information. - Uses various modules of the computer system to obtain information, query information and process orders and authorizations. - Accurately documents on the various platforms and computer syste...