Lead Referral Center Associate, VNA of Cape Cod bei Visiting Nurse Association
Visiting Nurse Association · Hyannis, Vereinigte Staaten Von Amerika · Onsite
- Professional
- Optionales Büro in Hyannis
- Takes lead in identifying, analyzing and streamlining referral/data entry process.
- Applies critical thinking to appropriately prioritize and triage calls, faxes and CCHC report information to Intake RNs, clinical staff and schedulers.
- Works collaboratively and professionally with other members of the health care team to ensure quality of services and patient safety.
- Maintains current knowledge of agency policies, procedures, objectives and current documentation requirements to meet regulatory standards.
- Obtain required clinical information that will enhance the admitting clinicians ability to conduct patient centered assessment in the home.
- Communicates information processed in the department to the appropriate managers, clinical staff, schedulers and other support staff.
- Transcribes information from community partners to the appropriate clinical documentation and communication software programs.
- Triages telephonic requests for services appropriately and provides information regarding agency services and program to the public.
- Prioritizes, collates and distributes referral information to schedulers, clinical, reimbursement, and accounts receivable.
- Verifies documents and reports specific payer eligibility and benefits for AR and Reimbursement.
- Identifies managed care, high risk and reduced fee status clients and maintains current awareness of insurance coverage benefits and Agency policy related to same
- Ensures prior and re-authorization for services is obtained as per the individual insurer and maintains documentation of all authorizations for services.
- In collaboration with the clinician, reviews clinical documentation for reimbursement including the parameters established by the individual insurer and the appropriate clinical practice guideline
- Other duties as assigned.
- Consistently provides service excellence to all patients, family members, visitors, volunteers and co-workers.
- Challenges current working practices; identifies process improvement opportunities and presents recommendations and solutions to management. Engages and commits to the organization’s culture of continuous improvement by actively participating, supporting, and promoting CCHC Pillars of Excellence.
- High school diploma or GED required. Associates Degree, Medical Assistant or Medical Secretary preferred.
- Word processing/data entry skills and knowledge of the use of basic office equipment required.
- Knowledge of medical terminology required.
- Customer service, problem solving, critical thinking, and interpersonal skills required.
- Three year’s previous experience working with insurance verifications and referrals in a medical field
- Two years’ experience in the medical field, health insurance or home care industry preferred.
