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Client Intake - Griffin, United States - CareMaster Medical Services
Description
CareMaster Medical Services -
Gather and assemble all information concerning patient background and specific referral requirements
Negotiate reimbursement rates for Private Duty cases with insurance/claims adjusters by providing all relevant information and orders to ensure that patient receive necessary care to aide in their recovery to enhanced quality of life
Ensure complete and accurate patient registration in EVV system, including demographics, medical history, care needs, and financial information
Maintain ongoing tracking and appropriate documentation on all referrals to promote team awareness and ensure patient safety
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Create detailed Referral Reports daily and Census reports weekly to be sent to CEO, CFO, DOO, Marketing, Clinical Liaison, and Department Heads to denote company and referral progress
Communicate all appropriate information to Care Coordinators, Clinical Liaisons, and Marketing on all incoming referrals
Collaborate with DOO and Clinical Liaisons to provide specific medical information to payor sources to maximize set reimbursement rates, increasing profit margins on all Private Duty cases
Act as the system navigator and point of contact for community members, family members, case managers, insurance adjusters, and referral sources to ensure strong relationships and future referrals
Advocate for patients and potential patients to ensure approval for necessary services and DME/supplies
Ensure that all Medicaid referrals are processed within 3 business days of receipt and Private Duty referrals are tracked and updated in a timely manner as the start of care dates approach by communicating with case managers adjusters, office staff, and family members to set appropriate admission dates by establishing payor source, gathering dynamics, and ensuring appropriate staffing is in place
Work closely with Human Resources to ensure that referrals in low-staff areas are worked on to hire caregivers and nurses
Make referrals to Area Agencies on Aging (AAA) or case management for Medicaid-eligible patients to assist them in connecting with resources to provide them in home care, working with Billing to verify benefits before sending in referrals
Create and bill all initial invoices for all Private Pay clients to ensure that payment and retainer is on file before services are rendered
Collaborate with the Billing Department to ensure that authorization for services is obtained on an on-going basis; send additional Letters of Agreements or PA/PO requests to case managers and/or adjusters
Speak to walk-in potential referrals about company's suite of services and conduct home visit information sessions, as needed
Communicate with Marketing on all referral inquiries to ensure that referrals are viable and billable, per CareMaster policies and licensure; cultivate positive working relationships with referral sources by communicating needs with them and advocating for their patients
As needed, work with Pharmacist and DOO closely on IV cases to ensure correct pricing, availability, and supplies are obtained
Assist DOO with administrative duties as assigned
Additional Notes: Works closely with department heads (Private Duty, Medicaid, HR), Clinical Liaisons, and Marketing. Position has no direct reports.
