External Scheduler REMOTE

This a Full Remote job, the offer is available from: New Jersey (USA) Join BoldAge PACE and Make a Difference!

• Why work with us?
• A People First Environment: We make what is important to those we serve important to us.
• Make an Impact: Enhance the quality of life for seniors.
• Professional Growth: Access to training and career development.
• Competitive Compensation:
• Medical/Dental
• Generous Paid Time Off
• 401K with Match*

• Life Insurance

• Tuition Reimbursement
• Flexible Spending Account
• Employee Assistance Program

BE PART OF OUR MISSION! Are you passionate about helping older adults live meaningful, independent lives at home with grace and dignity? BoldAge PACE is an all-inclusive program of care, personalized to meet the individual health and well-being needs of our participants. Our approach is simple: We listen to our participants and their caregivers to truly understand their needs and desires. External Scheduler SUMMARY: The External Scheduler is responsible for coordinating and maintaining participant schedules for services authorized by the program and related schedules to ensure seamless service delivery within the PACE organization. This role involves creating efficient schedules, managing changes, and communicating updates to all relevant parties. The External Scheduler works closely with interdisciplinary teams (IDT) to ensure timely service delivery, optimize resources, and support high-quality care for participants. Accuracy, organization, and effective communication are key to success in this position.

• ESSENTIAL DUTIES AND RESPONSIBILITIES:
• Daily intake and review of new referrals/orders and take action to complete the authorization and scheduling for assigned referrals/orders. Assignments are defined by manager for specific roles, with Scheduler typically assigned orders/referrals to external providers.
• Manage scheduling for participants for any related visits or services to meet both compliance requirements and ensure efficiency & accuracy to support participant satisfaction
• Utilize systems and/or research to identify to deliver ordered services and initiate Single Case Agreements (SCA) or Out of Network (OON) request, when applicable.
• All visits scheduled visits must be documented as completed, cancelled rescheduled daily
• Use the transportation system or related systems to confirm completed appointments
• Coordinate participant appointments, identifying he need for transportation for visits across various care settings, including clinics, home care, and community locations.
• Contact providers / access External EMR/EHRs for medical records& for scheduling
• For disenrollments, produce output of medical records and send to receiving provider(s)per IDT instructions
• Communicate schedule updates and changes promptly to participants, caregivers, and staff
• Address scheduling conflicts and resolving issues in a timely manner and must document within the system (e.g. Use of Comments)
• Collaborate with interdisciplinary team members to prioritize and address urgent scheduling needs.
• Maintain and update scheduling systems, ensuring accurate documentation and compliance with organizational standards.
• Monitor rejected claims and/or authorizations reports or systems to identify issues and research to resolve issues in a timely manner
• Monitor and adjust schedules to optimize resource utilization minimize disruptions.
• Participate in audits conducted by internal or external entities to audit and review participant records & related documentation and/or conduct peer review of work product for quality assurance purposes
• Track and follow specific scheduling metrics to meet requirements for provision of services
• Continuous improvement of process; identify areas for improvement and assist with implementing solutions and improvements
• Assist with special projects or other duties assigned to support operational goals.
• Engage in supporting and promoting Quality Initiatives.
• Follow all policies related to company ethics to maintain security and confidentiality for all company assets, property, and all information about participants, clients theirfamilies
• Maintain a safe working environment.  Follow Safety Policies and Procedures.
• Participate in any required staff and training meetings
• Perform other duties as required or requested
• EDUCATION AND EXPERIENCE:
• High school diploma or equivalent (required).
• 1–3 years of experience in health care administration – referrals, claims, order management, scheduling, administrative support, or healthcare operations (required).
• Knowledge of provider network management, payer requirements medical documentatio