About the role
Responsibilities
Hours:
Shift Start Time:
8:30 AM
Shift End Time:
5 PM
AWS Hours Requirement:
8/40 - 8 Hour Shift
Additional Shift Information:
Weekend Requirements:
As Needed
On-Call Required:
No
What You Will Do
Organizes and coordinates daily intake/referral processes for the home health agency to ensure that the initiation of care is timely and according to physician orders and within regulatory guidelines. Acts as the key linkage between hospital case management services, medical group physicians and office staff, hospice agencies and home infusion services. Responsible for the coordination of complex patient issues related to home care services.
Required Qualifications
- California Licensed Vocational Nurse (LVN) - CA Board of Vocational Nursing & Psychiatric Technicians - REQUIRED
Preferred Qualifications
- 1 Year Home health experience
- Experience as a home health liaison or community outreach coordinator
Essential Functions
- Completes insurance verification and authorizations
Verifies patient's eligibility and coverage by calling their insurance company.
Notifies each family/patient of their co-pay
Contacts insurance case managers for negotiation of rates.
Obtains initial authorization on all managed care and private insurance cases.
Communicates with staff regarding follow up for continued authorization.
Communicates with the insurance prebillers by relaying pertinent information. - Referral management
Completion of service requests
Follow up with physicians for specific treatment orders
Informs patients/families of scheduled assessment visits.
Establishes courteous rapport with patient
Calls each referral to confirm address, telephone number, spelling of their name, Primary Care Physician (PCP) and informs them that the discipline will be calling to set up the appointment.
Exhibits flexibility and adaptability by meeting the changing needs of the agency. - Referrals
Coordinates referral process with home health liaisons.
Ensures that all patients are appropriately documented on the log, including pertinent information for staffing purposes. - Triage
All inquiries are screened and converted to home health referrals when appropriate based on agency admission criteria.
Refers all other callers to the appropriate community resource based on the information obtained.
Knowledge, Skills, and Abilities
- Knowledge and experience of overall home health management including admission criteria, nursing process, insurance limitations, referral process, etc. is preferred.
- Must have experience with handling difficult situations applying empathy, courtesy and compassion.
- Experienced with using different approach when working with co-workers, staff and the public.
- Must assume a position in the weekend rotations.
- Basic knowledge of insurances including Medicare/Medi-Cal and HMO limitations is required.
Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class.
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