HOME CARE COORD INTAKE-PEH Espanola FT .9 Job Listing at Presbyterian Health Services in Espanola, NM

Hospital / Healthcare, Health Products & Services

HOME CARE COORD INTAKE-PEH Espanola FT .9
Requisition Number: 41866
Location: NM-Espanola
Type of Opportunity: Regular Full-Time
FLSA Classification: EXEMPT
Minimum Experience: 3 years
Minimum Education:
Shift: Days

Minimum Skills/Requirements

Graduate of an accredited School of Nursing and an Associate degree in Nursing or a three year nursing school graduate or a Bachelor's degree in Nursing. At least 5 years clinical experience is required. Knowledge of utilization management, principles, Medicare conditions of participation, for services, Medicaid benefits, home health care, skilled nursing facility/long term care, home infusion and durable medical equipment is highly desirable. NM/RN license required.

Primary Job Functions

• Receives incoming calls from all sources and transcribes the necessary information to process a referral for transmission to the clinical team for scheduling of the admission assessment of the patient.

• Develops and maintains a working knowledge of all service and resources available within the company and the community.

• Enters the necessary demographic information to process the referral and admission of the patient into the computer system.

• Accurately obtains and transcribes initial orders for home care services and ensures follow up with any requests or orders.

• Makes recommendations for referral to alternate and appropriate inpatient, outpatient and/or community resources when Homecare is not appropriate.

• Identifies all potential payer sources and establishes the primary payer, provides patient care reps with patient payor information for verification and ensures insurance information is complete.

• Negotiates fees with commercial insurance companies to cover needed home care services and support the financial goals of the PHH organization.

• Initiates pharmaceutical orders or all home infusion cases, as appropriate.

• Meets internal and external customer service expectations.

• Monitors referral source satisfaction through phone follow-up regarding referred patients.

• Maintains referral information on appropriate logs.

• May be responsible for obtaining physician information necessary to maintain accurate records for each referring physician.

• Assumes responsibility for professional growth and development.

• Performs other duties as assigned.