Main Function: Assumes the responsibility of the department for coordinating potential client admissions to both A Pineywoods Home Health and Home Services and referring entities to enhance and expedite care.
Essential Tasks:
Intake:
- Supervises and Coordinates with Intake Department to ensure appropriate patients are accepted for admission by both A Pineywoods agencies by:
- Gather appropriate information for admissions to the agencies thru phone or faxed referrals and present the information to the responsible party for acceptance as admissions.
- Responsible for coordinator and oversight of appropriately obtaining insurance verification and authorization for assigned managed care insurance programs for visits requested by clinicians.
- Reviewing initial referral information to provide required clinical documentation to providers for authorization.
- Consulting with the Administrator/ Alternate Administrator /Clinical Care Manager to determine if the agency can meet the needs of the client.
- Coordinating with Parent/Branch Clinical Care Managers or Administration as needed to determine acceptability of client for admission.
- Presenting the initial referral including HIQH, insurance, history and physical, and face-sheet to the Parent/Branch Clinical Care Manager for follow up and assessment of admission.
- Assisting with scheduling as needed by staffing patient cases with the correct discipline.
- Verifying all payer sources and benefits including private pay, Medicare, Medicaid, VA, or private insurance. Negotiate rates within the company’s accepted standards as directed by the CFO.
- Obtaining HIQH on all Medicare clients initial and re-certifications.
- Obtaining faxed/electronic physician orders for evaluation and/or treatments. If verbal orders are needed, coordinating with an appropriate discipline to obtain the order for admission.
- Tracking and log referrals weekly per office.
- Reviewing referral reports with the Director of Marketing and Administrator every week.
- Tracking and follow up on pending referrals.
- Utilizing Medicare/Palmetto and other regulatory body criteria for admission of Home Health care determining appropriate levels of care.
- Maintain knowledge of current regulatory criteria regarding admissions.
- Manages internal and external referrals for caregiver services.
a. Manages referrals from Home Health for Home Services
b. Communicates with social worker for referral related follow-up
processes
- Medicaid eligibility status checked on the 1st and 15th of each month for Home Services.
- Manages all requests for private pay clients for caregiver services.
- Negotiates contracts for private caregiver services with potential patients and family members and coordinates with administrator and alt. administrator for contract approval.
- Contact referral sources if a trend of decline from the source occurs to determine if a perceived problem needs to be addressed. Update the Marketing Director, Clinical Care Manager, and Administrator as needed for corrections.
- Quality Improvement review admits as needed.
- Assist in the planning, development and operation of the Intake workflow
- Assist in the preparation of Intake reports, weekly and monthly Intake reconciliations, admissions and referral trends.
- Analyze intake and admissions data for accuracy and completeness.
- Track and trend intake data and identify opportunities to increase referrals and efficiencies within the department.
- Understand and ensure the Intake Department follows all HIPAA, compliance, privacy, safety and confidentiality standards and processes.
- Meets with the Administrator and Billing department to ensure timely authorizations are received and problems are identified.
- Visits referral sources when needed to ensure effective communication is achieved and maintained.
- Receives reports from intake personnel daily to ensure processing of referrals are timely
- Ability to utilize virtual meeting platforms when required.
- Able to utilize electronic forms of documentation/communication such as Teams, Google, Wellsky.
- Other duties as required
*
Education and Experience:
*Current and Valid LVN License
1. High school diploma or completed GED.
2. One year of home health care experience.
3. One year of supervisory experience preferred.
4. One year of experience in a Long Term Care home setting is preferred, but not required. Demonstrated ability or education in the same areas is preferred.
Minimum Tools and Equipment Required:
- Compute
- Office phone
- Fax machine
- Automobile and Insurance
- Home telephone
- MS office (Word, Excel, Teams, Email),
- Google Drive (Docs, Sheets, Forms)
Skills and Abilities:
- Is able to work in various environments
- Is able to work as scheduled and report to work on time.\
- Is able to lift a minimum of 20 pounds..
- Has good visual acuity.
- Must be able to analyze situations, cost and products.
- Can handle multi-tasks and multi-deadlines.
- Handles emergency situations well.
- Is able to work in a stressful environment and recognize the need for self-relief.
- Has excellent guest relation skills.
- Has excellent planning and organizational skills.
- Has excellent time management skills.
- Communicates well orally and in writing.
- Has access to personal transportation.
- Is able to operate an automobile and travel up to 50-100 miles a day.
- Complies with agency policies and procedures.
- Excellent leadership skills.
- Understands and will comply with the chain of command.
- Able to work a minimum of 40 hours per week.
- Able to read, comprehend, and comply with instructions from company manuals.
- Able to comply with agency and CDC infection control protocols.
Job Type: Full-time
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Medical Specialty:
- Home Health
License/Certification:
- BLS Certification (Preferred)
- LPN (Preferred)
- LVN (Required)
Work Location: In person
