Hybrid Care Specialist at Arrow Child and Family Ministries

The Care Specialist is responsible for the coordination of all in office tasks associated with durable medical equipment services to Medicaid eligible children in conjunction with the family, prescribing doctor, and managed care organization. Additionally, Care Specialists will process referrals, establish service eligibility, confirm service authorizations, and track ongoing utilization of products, service eligibility and authorization renewals. Care Specialists will also ensure that the members’ supplies are personalized according to the referring physician’s prescription and products specified are delivered discreetly and timely as they relate to the child’s needs in the home.

• Medical, dental, vision, and supplemental insurance options, including HSA match for qualifying contributions.
• Parental Paid Leave
• Retirement savings plan with company match.
• Paid time off and holiday pay.
• Mileage reimbursement.
• Tuition reimbursement available.
• Company sponsored learning and development

Other duties may be assigned as necessary.

• Responsible for Intake activities of assigned office location(s).
• Ensure the timely and effective provision of required services, prior authorizations, and re-authorizations.
• Respond to all incoming referrals inquires within 24 hours.
• Regularly advises referring agencies of service eligibility through correspondence, presentations, and collaborative meetings.
• Secure information such as diagnosis, demographics, PCP and insurance status to determine eligibility for services.
• Responsible for handling crisis referrals outside of business hours.
• Ensure utilization of services is within the guidelines of insurance coverage.
• Provide durable medical equipment care coordination services to children and families.
• Review detailed written order/prescription, LOMN’s, HCPC coding, ICD-10, patient information, and insurance information.
• Timely submission of Title XIX authorizations/reauthorizations according to payer requirements and following specific state and federal standards.
• Maintain files on all clients receiving Medicaid services.
• Routinely fax requests to doctor’s offices and/or hospitals and follow-up when necessary.
• Accurately follows and maintains patient, account and client confidentiality at all times. Adhere to HIPAA and compliance policy guidelines.
• Ensure professional verbal and written communication with facilities, clients, field staff and co-workers.
• Input and update child and family information into the Arrow client information system.
• Attend trainings and meetings as required.
• Share/transmit the mission and vision of Arrow Child & Family Ministries to staff and to clients and families served.
• Perform all duties within contract, state and federal regulations, company policy, and regulatory agency standards.
• May be required to drive vehicles, be insurable with our auto insurance provider, and complete company vehicle training.

High School diploma or GED, and at least one (1) year of related experience.  Bilingual in Spanish is highly preferred. Bachelor’s degree preferred as well.