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CareGivers America - NEPA, a Modivcare Personal Care Service, is looking for an Intake Coordinator who reports directly to the Branch Manager. Responsibilities include evaluating patients referred to the Organization; identifies insurance coverage, negotiates payment or rates; plans and coordinates referrals for home care services.
Job Responsibility:
Evaluate patients referred for home health services
Identify and verifies insurance coverage of home health care services
Obtain and documents prior authorization for home care services from insurance providers
In collaboration with a clinical manager, negotiate payment rates for creative bundling of home care services
Collaborate with the discharge planning personnel, utilization review department and insurance Case Managers to facilitate safe discharge to home health
Consult with physicians, nurses, social workers, discharge planners and other disciplines to establish a coordinated home plan of care
Interview the patient, family, and caregiver and discusses the home situation, current needs, and any psychosocial factors that are relevant to the plan
Complete referral information that includes intake data, essential background information, hospital course, and the plan of care
Maintain liaison relationship with hospitals, facilities, physician offices and insurance personnel, providing information and education on Organization services, coverage issues and related areas
Responsible for collaborating and coordinating with the management team regarding: Employee orientation
Collaborate with clinical management staff to ensure proper staffing of qualified, competent personnel
Responsible to attend staff meetings and other clinical meetings to facilitate coordination of care
provide input as needed
Participate in the administrative/back-up on-call schedule and in the first call rotation when needed
Participate in Quality Assurance Performance Improvement (QAPI) reviews and projects as requested
Ensure accuracy, completeness, and timeliness of clinical documentation in accordance with Agency policies and procedures, regulatory requirements, and industry standards
Provide support and direction to Agency staff, other health care professionals, clients, and families related to appropriate and available health care resources
Facilitate problem-solving sessions to enable nurses and other staff to resolve client and/or reimbursement source issues
Stay current on available community resources, health care costs, and industry trends through self-education and access to outside educational opportunities
Develop working relationships with other health care professionals in the community and families to identify resources available and to ensure access of information to clients
Follow Agency guidelines for disciplinary actions. Documents all disciplinary actions in accordance with policy
Promote personal safety and a safe environment for clients and co-workers. Takes the initiative to help prevent accidents and promote safety
Demonstrate knowledge of safety/infection control practices by compliance with policies and procedures and regulatory requirements
Perform other duties as assigned
Requirements:
High School Diploma/GED or equivalent experience
Minimum of two (2) years of experience in a home care or home health setting preferred
Experience with prior authorization processes
Excellent verbal and written communication skills and strong interpersonal skills
Demonstrates an ability to work with other health care clinicians, development of home plan of care, knowledge of third party reimbursement, and ability to negotiate payment rates
What we offer:
Medical, Dental & Vision Insurance
401(k) with a 6% match
Paid Time Off
Employee Assistance Program
Employee Discounts (retail, hotel, food, restaurants, car rental, and much more!)