- Work closely with the Clinical Team Managers and the Home Care Utilization Navigator in the following: a. Ensure all clinicians on team consistently meet productivity expectations.
- Review initial admission information to provide required clinical documentation to
- Tracking of medical documents for commercial insurances and Medicaid to ensure patient schedules and authorizations are compatible.
- Continually provides managed care organizations with clinical documentation to comply with payer' requirements to obtain reimbursement.
- Follows through in a timely manner to request/obtain service authorizations per the insurance defined procedures.
- Processes reconsiderations and appeals of denials for service as appropriate. Review ongoing retroactive reimbursement issues.
- Maintains updated managed care/reimbursement manuals.
- Interprets agency policies and criteria for service to insurers, fiscal intermediaries, patients/families, physicians, and the public.
- Ensure compliance of home health aide (HHA) supervisions when HHAs are referred on certified home care patients.
- Ordering of supplies for patients/field staff.
- Organizes and monitors skills checklist of clinicians on team.
- Maintain knowledge of JCAHO and DPH regulations as well as agency policies and procedures.
- Communication with patients to discuss and collaborate schedule of certified nursing, therapy, and medical social work visits.
- Notifies client/family of schedule changes.
- Scheduling of all clinicians in the team to ensure they meet their daily productivity expectations.
- Controls and monitors schedule changes and works closely with the team to ensure efficient and coordinated high quality patient care.
- Fielding phone calls emails, etc. from clinicians regarding their schedules.
- Daily collaboration with Clinical Team Managers, Home Care Utilization Navigator, paraprofessional department, and clinicians to promote high-quality patient-centered care.
- All other duties as assigned.
- High school graduate or equivalent required.
- General knowledge of home care preferred.
- Some knowledge of insurance authorization/utilization process for home care preferred.
- Outstanding customer service and interpersonal skills.
- Must work well in a team setting which will promote the quality and efficiency of the team which positively impacts patient-care.
- Exceptional time management and organizational skills.
- Ability to perform detailed work independently without constant supervision in a fast paced environment.
- Must demonstrate efficient computer and technology skills.
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Cape Cod
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Cape Cod
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LPN, VNA of Cape Cod
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audiologist - cape cod
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rn evening mna, vna of cape cod
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rn primary mna, vna of cape cod
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Psychiatrist Cape Cod Region
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Sales Mgr. Cape Cod
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Psychiatrist Cape Cod Region
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Weekend Homecare Utilization Assistant, VNA of Cape Cod - Plymouth, United States - Cape Cod Healthcare Inc.
Description
c. Coordination/scheduling of IDTs.
CARES:
compassion, accountability, respect, excellence and service.
