Job Description

ESSENTIAL JOB RESPONSIBILITIES:

· Completes insurance verification and regulatory requirements for referred patients for hospice, home health and palliative care. Re-verifies on admission and completes payor setup in chart.

· Completes hospice, home health and palliative care authorization requests on admitted patients and updates the electronic health record timely.

· Documents new, pending and re-authorization requests in EHR. Coordinates with primary care physician offices for HMO plans.

· File notice of election paperwork to Department of Children & Families for Medicaid patients.

· Communicate daily with nursing homes and complete the nursing home reimbursement form upon admission.

· Protects the confidentiality of patient and organization information through effective controls.

EDUCATION AND QUALIFICATIONS:

· High School Diploma/GED required, Associate's Degree preferred.

· Two to four years of relevant experience required.

· Knowledge of home health and hospice experience preferred.

· Billing and authorization information systems knowledge required, KanTime preferred.

· Knowledge of third party and governmental payer requirements in order to obtain authorization.

· Knowledge of Florida Medicaid requirements and processes.

· Competency in using all industry based software related to job responsibilities (Waystar, Ability, Availity, Medicaid, et al)

· Able to deal tactfully with patients, family members, referral sources and payers.

· Knowledge of Microsoft Excel.

· Knowledge of governmental regulations and billing guidelines.

All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance.