Intake Coordinator / Specialist

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LINK TO NEW INTAKE COORDINATOR FORM NEEDED FOR APPLICATION TO BE CONSIDERED -> https://forms.gle/kMHwFHWcK1vBF6yT8
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Job description
Intake Coordinator/Specialist
Established Home Healthcare Company looking for an Eligibility/Intake/Authorization Specialist to join our fast-paced and motivated team!
The Position Summary:
The specialist works to ensure standardization, best practices, and compliance with various commercial insurance guidelines. They will also be responsible for the implementation and enforcement of the policies and procedures for the direct purpose of obtaining and maintaining eligibility and authorizations for patients. The specialist will be responsible for maintaining positive relationships with customers and referral sources and will respond to customer requests and concerns.
ESSENTIAL JOB FUNCTIONS/RESPONSIBILITIES:
• Comply with applicable legal requirements, standards, policies, and procedures including, but not limited to the Compliance Program: Code of Conduct, HIPAA, and Documentation Standards.
• Directly responsible for each Eligibility and Authorization Case and keeping up to date on the current status (i.e. visit maximum, length of authorization, policy status, etc.).
• Assists with implementation of improved work methods and procedures to ensure patients are verified and authorized in accordance with policy.
• Provides strategic planning including identifying opportunities for additional or improved workflow to meet customer needs.
• Serving as the initial point of contact for new inbound referrals via phone, email, fax, etc.
• Maintains comprehensive working knowledge of commercial contractual guidelines and ensures that patients are admitted according to contract provisions as well as the current updates of Federal and State rules and regulations pertaining to eligibility and inform staff of these changes.
• Maintains positive working relationships with current and potential referral sources and staff associated.
• Receiving all inbound calls and forwarding them to the appropriate team members as needed
• Conveying any new information regarding patients in a timely manner to the appropriate team members and documenting in the EMR
• Determining if a referral is ready for clinical review or if it is deficient in any way
• Collecting, reviewing, and consolidating clinical referral documents for clinical review
• Collaborating with the clinical, staffing and marketing team on accepted, pended, or denied referrals
• Verifying insurance through provider portals (Availity, Cigna for HCP, UHC Link, etc.)
• Tracking and following new, existing, and potential readmit patients in coordination with the marketing team
• Maintaining appropriate records, files, documentation, etc.
• Assisting in the development of new processes within the intake and referral process in collaboration with the clinical, operations, and marketing teams
POSITION QUALIFICATIONS
• Minimum of five years of experience determining eligibility/benefits and authorizations for Commercial Carriers.
• Minimum of one year experience in home health/home care/home infusion insurance verification.
• Working knowledge of medical terminology
• High school diploma or equivalent is required
• Computer Proficiency – MS Office
• Excellent verbal and written communications skills
• Meets all productivity requirements
• Ability to work independently in a team environment
• Prolonged sitting and some standing required. Occasional need to lift, pull, carry and push items weighing up to 50 pounds.
• Develop standard operating procedure (SOP) documents
• Work directly with our revenue cycle management vendor
• Experience with Office Ally and Availity a plus
Job Type: Full-time
Benefits:
• Healthcare including medical, dental, vision
• Paid time off
Schedule:
• Wednesday-Friday 2-8 Weekends 10-7

Experience:
• Insurance verification: 5 years (Preferred)
• home health authorizations: 1 year (Preferred)
• authorizations for Commercial Carriers: 1 year (Preferred)
• Office Ally: 1 year (Preferred)