Homecare Service / Referral Coor- Homecare Administration

Works in partnership with Clinical Coordinators of business lines to assure service coordination for NCHH patients. Coordinates receipt of initial and ongoing clinical, demographic, and financial data for Intermittent/Therapy Clinical Services, Pharmacy, PDN, DME, Hospice/Palliative Care, and Synagis referrals. Communicates with third party payors and case managers relative to patient's coverage and home health benefit package. Demonstrates competencies defined (*) in Service Coordinator responsibilities in providing age-appropriate care to patients from the age of birth through 21 years, and select adult patients.

Schedule: (Full time, Non-Exempt)

In Office position at 255 E. Main
Mon-Fri
8-5

Location:

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* Performs initial and ongoing coordination activities with Intermittent/Therapy Clinical Services, Pharmacy, PDN DME, Hospice/ Palliative Care, and Synagis. Disseminates patient and program information, coordinates patient services and schedules with service line/clinical coordinators as needed.
• Collects and documents initial payer source information.
• Verifies service/therapy coverage with public and private insurers.
• Initiates continuation of ongoing and new therapies for existing patients, completes and distributes information as appropriate. Communicates ongoing patient information with NCHH pharmacy, PDN, primary nurse, and appropriate service line/clinical coordinators as needed, and coordinates staffing needs with the family.
• Maintains ongoing patient information in the current information system/systems including the admit/discharge status of patient and or therapies, as well as reconciling patient medication upon admission/discharge at NCH.
• Obtains reimbursement follow-up information including, Financial Agreement and Notice of Non-covered Services form as appropriate. Also initiates CMN and obtains Letters of Medical Necessity for third party authorizations and Medicaid prior authorizations as appropriate. When there is not a face-to-face contact with a patient, the Homecare Service/Referral Coordinator will review all Patient Packet information with the family.
• Coordinates the scheduling of clinical services to meet referral demand and physician orders involving current patients.
• * Receives and coordinates initial and ongoing physician orders related to care, treatment, and services with the appropriate service line/clinical coordinators.
• *Collaborates with service lines to ensure an appropriate supply list for individual patients according to physician ordered services / therapies.
• NCHH Homecare Service/Referral Coordinator is responsible for requesting Face to Face forms as appropriate.
• Completes correct ICD-9 coding on an initial and ongoing basis.
• Collects data related to denials for therapies or cases.
• Performs data entry of initial patient information within acceptable timeframe according to NCHH policy and procedures.
• Assembles and distributes appropriate documentation forms/charts for initial and ongoing homecare services and maintains working files as needed while cases are open.
• Documents clinical functions (physician orders, progress notes, etc.) and coordination activity information accurately and in a timely manner.
• Responsible for generating and attending Morning meeting as assigned, as well as attending the IDT meetings for our Hospice/Palliative Care patients as assigned.
• NCHH Service/Referral Coordinator is responsible for getting Medimmune Patient Access Program information to appropriate patients and maintaining Medimmune Reports for the Synagis program.
• Communicates using excellent customer relations with patients, parents, visitors, referral sources, case managers and co-workers.
• Assists, as appropriate, in complying with applicable: federal, state and local laws; Medicare / Medicaid Conditions of Participation; JCAHO standards; State of Ohio Day Care Licensing; State of Ohio Waiver regulations; and any other appropriate accrediting or regulatory body.
• Participates as directed in marketing efforts and community endeavors.
• Participates in drills (including fire, bomb, tornado, weather disaster, community disaster, etc.) and ICES Rounds and follow up, as directed, to ensure the safety of patients, families, staff, students, vendors, visitors to the CHS building, etc.
• Awareness of need to balance cost, quality, and mission.
• Performs basic skills in the following: phone communication, computer skills (word processing and data entry),communication, organizational/multi-tasking, customer service, team building, management/leaderships skills as appropriate, negotiation, conflict management, decision making, and diplomacy skills.
• Maintains confidentiality of all patient/agency information.
• Assumes responsibility for continued professional growth.
• Supports agency-wide patient care activities as appropriate to the role.
• Performs other duties as assigned.
• Make appropriate referrals, manage coordinate resources, coordinate/collaborate on all services (internal and external), match resources available to referral needs/accept referral, match practice with authorized allowable with patient needs, discharge patient form service, communicate discharge request/order to all appropriate customers.
• Develop/finalize/revise/update/terminate service agreements.
• Anticipate, manage and evaluate patient needs, and serve as a resource to other personnel.
• Provide initial/ongoing advocacy, customer service and communication with families and all customers.
• Coordinates, facilitates, and provides a support function for all service lines.
• Maintains patient referral source and documentation logs for ongoing patient therapies.
• Evaluates teams assignments as needed.

KNOWLEDGE , SKILLS AND ABILITIES REQUIRED:

Education:

• Associate's degree in medical-related field, or office/business preferred or equivalent home health experience required.

Preferred Experience:

• Ability to type on a computer keyboard, working knowledge of Window-based applications.
• Knowledge of Medicaid, HMO, insurance regulations, and managed care as they affect home care agencies is highly desirable.
• Aptitude for detail; strong organizational skills with multitask ability.
• Effective interpersonal and customer service skills.

Minimum Physical Requirement:

• Sitting Constantly (67-100)
• Talking on phone or in person Constantly (67-100)
• Finger dexterity Constantly (67-100)

The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individual so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under his/her supervision.

EOE M/F/Disability/Vet