This list contains only the countries for which job offers have been published in the selected language (e.g., in the French version, only job offers written in French are displayed, and in the English version, only those in English).
Responsible for the screening and accurate completion of referrals to ensure patients meet agency admission criteria and comply with state and federal regulations
Processes referrals for all programs (Traditional, Peds, and Infusion Therapy) from hospital sites, MD offices, utilizing standard work and determines whether patient qualifies for home care based on established guidelines
Verifies home health care benefits according to payor plans
Obtains authorizations for services as indicated
Ensure physicians initial home care orders are obtained
Identifies risk management situations and completes high risk referral process on all appropriate patients based on established guidelines
Interprets company services, admission criteria and medical policies to referral sources and individuals seeking information
Documents the initial plan of home health care and initiates interdisciplinary communication
Interviews patients/families in the hospital or SNF, to assess and evaluate patient for home care appropriateness
Works in conjunction with the care management staff to assist the patient/family in the initiation of home care services
Responds to inquiries regarding home care services
Works within established productivity guidelines for assigned site(s)
Reports productivity to supervisor daily
Trains patient/families in using equipment (e.g. pump) at home
Provide quality customer service
promote collaboration/coordination between referral sources and home care services to promote continuity of care and utilization of home care resources effectively
Acts as a resource to physicians, physician offices, patients and families, hospital and designated skilled nursing facility staff (i.e. care management, discharge planners, social workers, nursing) regarding types of services available and the criteria for home care, including Medicare guidelines
Provides education to the care team as requested on services that may enhance the transition of care for patients including DME, Hospice, Palliative Care, Pediatrics and Home Infusion Therapy
Maintains knowledge of Medicare, Medicaid and HMO procedures
Attends site based multidisciplinary meetings (e.g. readmissions, capture, discharge planning) that involve Advocate at Home patients
Assures appropriate follow-up to patient satisfaction issues relating to home care services
Provide courteous service to patients, families, staff, and physicians
Accountable for insuring complete referral information is obtained for accurate and timely billing
Maintains knowledge of agency payers including Medicare, Medicaid and contracted commercial insurance reimbursement guidelines
Collaborate with insurance verification to insure optimal reimbursement
Assists in the development of policies and procedures to ensure compliance with current practice standards
Obtain Face-to-Face (F2F) encounter form for all Medicare, Medicaid and Medicaid pending patients during referral process or within first 7 days
Educates physicians in the Face to Face process
Teamwork
Maintains own clinical skills and competency by attending monthly training and interdisciplinary team meetings
Provide suggestions or improvements in current practices (i.e. process, documentation, etc.) to improve quality, productivity and customer satisfaction
Provide a positive attitude for Advocate at home through self-management
Provide input regarding performance and compliance to standards of peers
Adapt to changing business needs, conditions and work responsibilities
Partner with peers to ensure productivity levels are achieved
Follow standard operating procedures and guidelines during referral processing to insure consistent messaging and superior customer service is provided
Participate in precepting new hire training and orientation
Partner with your peers and other Advocate at Home product lines to provide complete and thorough patient hand-offs when appropriate
Requirements:
RN with 3-4 years’ experience
1-2 years in home care preferred
Very good communication skills
Knowledge of Medicare rules and regulations
Experience in multi-tasking on multiple computer systems
Strong customer service skills
Working knowledge of managed care environment
Critical thinking skills
Current RN licensure
Ability to lift up to 35 pounds without assistance
What we offer:
Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs