Intake/Benefits Coordinator

KPH Healthcare Services • Full-time • Hoffman Estates, IL, US • 5d ago

Overview

Job Summary: Responsible for managing all aspects of the client intake process including managing the members of the intake team, establishing, and maintaining positive relationships with customers and referral sources, responding to customer requests and concerns, and managing the insurance verification and authorization processes.

Responsibilities

Job Duties:

Directs daily referral and intake operations including providing direct oversight of the establishment and implementation of intake
Ensures compliance with State, Federal, and other referral/intake regulatory
Directs the implementation of improved work methods and procedures to ensure clients are admitted in accordance with
Establishes and maintains positive working relationships with current and potential referral
Ensures maximum third-party reimbursement through insurance verification and authorization
Assists in negotiations for service pricing with insurance Case Managers and other payers within established financial and credit
Builds and monitors community and customer perceptions of HOME LIFE HEALTHCARE, CORP. as a high-quality provider of
Gathers, collates, and reports referral statistics including key customer referral
Maintains comprehensive working knowledge of HOME LIFE HEALTHCARE, CORP. contractual relationships and ensures that clients are admitted according to contract provisions.
Maintains comprehensive working knowledge of community resources and assists referral sources in accessing community resources should services not be provided by HOME LIFE HEALTHCARE,
Handles all telephone calls regarding scheduling and coordination of service delivery personnel to meet client scheduling
Accepts assignments from the Director of Nursing or Chief Clinical Officer
Schedules personnel
Contacts individuals’ assignments and scheduling
Receives a comprehensive "report" of staffing and service activity from the on-call coordinator
Coordinates client requests for service
Accurately schedules clinician in EMR (Kinnser) as needed and notifies clients regarding the status of their services
Assists in determining client needs and provides general information regarding services
Coordinates personnel scheduling requests as needed
Accurately records employee availability and coordinates availability with service requests
Notifies personnel in a timely fashion if the client cancels a request. Makes every attempt to reschedule agency personnel on another assignment
Contacts personnel, as needed, to request availability to work
Maintains an accurate telephone log of all communications with agency personnel and referral sources

Consults with the case manager or supervisor for any of the following:
Clients needing initial or emergency assessments
Inability to staff a client
Client complaints unable to be resolved
Service delivery personnel complaints or issues unable to be resolved
Clinical issues or problems needing the attention of a nurse
Provides "on-call report" to the supervisor each evening
Reports status of assignments given by the supervisor that day
Reports service requests received during office hours and the status of the requests
Reports information received from or about personnel including:
Availability received (dates, times, )
Changes in personnel status (active, inactive, part-time, )
Changes in personnel addresses, phone numbers,
Problems in scheduling or actions requiring disciplinary action
Any other information which might be useful to the supervisor in providing quality services to clients
Benefits and Authorization
Verifies third party reimbursement coverage
Follows up on pending unresolved coverage issues
Obtaining initial authorization from payer sources to begin services
Obtains authorization from insurance companies and keep tracks of any pending authorizations and overdue
Assisting with resolving insurance issues, reauthorization, and eligibility issues.
Verifying eligibility on a continues basis with all insurance carriers
Communication payer verification or benefits issues
Facilitating follow-up with payer staff/case managers regarding ongoing services, eligibility and authorization
Responsible for completing all mandatory and regulatory training programs
Perform other duties as assigned

Qualifications

Job Skill Requirements:

Complies with accepted professional standards and practice
Two years’ experience in intake/ scheduling position, preferably in private duty or home health
Has an ability to market aggressively and deal tactfully with vendors and referral sources
Has knowledge of corporate business management, governmental regulations, and private payer practices.
Demonstrates good communications skills, negotiation skills, and public relations
Demonstrates autonomy, organization, assertiveness, and flexibility and cooperation in performing job
Is self-directed with the ability to work with little
Has excellent coordination and communication skills.

Educational Requirements:

Associates Degree

Experience:

At least 2 years experience in Home Health or similar field.

Special Conditions of Employment:

Drug test
Initial and continuous exclusion and sanction/disciplinary monitoring
Any and all additional eligibility requirements based on the specific position

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