Company:

Providence at Home with Compassus

 

Position Summary

This position is responsible for initiating and coordinating referrals, gathering all necessary referral and payor information and then inputting into EMR, verifying patient information and initial eligibility with patient and referral source, and coordinating and scheduling date for HH admission. This position ensures that information obtained at time of referral is accurate and complete.

MAJOR CHALLENGES:
1. Ability to critically think and solve complex problems when processing referrals.
2. Ability to coordinate multiple tasks and to prioritize according to established time lines and unexpected emergent requests.
3. Ability to access and productively use multiple software programs.
4. Ability to effectively communicate with internal and external HS customers.

 

Position Specific Responsibilities

• Coordinates and processes incoming referrals, including assessing for needs from other HS departments.

• Evaluates referral information and contacts patient and or referral source and responsible for determining initial eligibility for HH services.

• Coordinates and ensures insurance information is obtained and accurately recorded into electronic medical record (EMR).

• Coordinates and evaluates patient information for referrals within guidelines.

• Accurately documents referral information utilizing critical thinking skills.

• Responsible for triaging and coordinating with appropriate team members for review if incomplete.

• Serves as a liaison between referral sources, MD office, patients/families, department supervisors, managers, insurance team, Access RNs to ensure timely patient care.

• Coordinates and communicates with appropriate team members to ensure service standards are met.

• Oversees all fax communications: triages faxes, contacts referral source to ensure complete referrals and coordinates the electronic referral system.

• Responsible for coordinating accurate insurance information and problem solves insurance eligibility with insurance team.

• Utilizes critical thinking skills to coordinate and assign appropriate start of care date under clinical guidelines utilizing clinical staff as appropriate.

• Coordinates with referral sources, inclusive of hospital, physician, facility customers and insurance case managers to obtain additional information, confirm referral receipt and communicate start of care date.

• Measures productivity and manages team assignments as needed.

• Prepares specific reports as directed for distribution within Home Health and other departments.

• Responsible for staying current on CMS regulations and maintaining current knowledge of Home Services products and services, and other referral sources.

• Seeks at all times to enhance Home Services Departments relationship with referral and reimbursement sources.

• Participates in Access Services and Insurance Staff meetings and education sessions.

• Performs other duties as assigned.

 

Education and/or Experience

Required - Coursework/Training Educational coursework in medical terminology. Or equivalent educ/experienceOR:
Preferred - Bachelor's Degree

Skills

Mathematical Skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percentage.Language Skills: Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from leaders, team members, investors, and external parties. Strong written and verbal communications.Other Skills and Abilities: Ability to communicate in a clear, concise manner both verbally and in writing.Computer Skills: Excellent computer skills.Computer Skills: Excellent Microsoft Office Suite software skills.Other Skills and Abilities: Ability to understand, read, write, and speak English. Articulates and embraces integrated healthcare at home philosophy.Other Skills and Abilities: Ability to work independently in a high volume environment.Other Skills and Abilities: Ability to think critically and to work with complex detail.Other Skills and Abilities: Excellent time management skills.Other Skills and Abilities: Ability to efficiently establish priorities.Other Skills and Abilities: Ability to problem solve.Other Skills and Abilities: Ability to work effectively in a team.Other Skills and Abilities: Excellent organizational skills.Other Skills and Abilities: Ability to multi task in a fast paced work environment.

Certifications, Licenses, and Registrations:

No Requirement

Physical Demands and Work Environment: The demands of this role necessitate a team member to effectively perform essential functions. Adaptations can be made to accommodate team members with disabilities. Regular standing, walking, and manual dexterity are fundamental, along with the ability to lift and move objects up to 50 pounds. Visual acuity requirements include close and distance vision, color and peripheral vision, depth perception, and the ability to adjust focus. In a healthcare setting, exposure to bodily fluids, infectious diseases, and conditions typical to the field is expected. Routine use of standard medical equipment and tools associated with clinical care is essential. This description provides a general overview and may vary by role and department, capturing the nuanced demands and conditions inherent to clinical positions in our organization.

At Compassus, including all Compassus affiliates, diversity, equity, and inclusion are fundamental to our Pillars of Success. We are committed to creating a fair work environment where our team members feel welcomed, highly valued, and respected. As an equal opportunity employer, all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

Compensation range: $23.39-$35.78

 

The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities

 

Compassus offers a comprehensive benefits package including, Medical, Dental, Vision, 401k and much more

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