Homecare Service / Referral Coor-Homecare Administration

Nationwide Children's Hospital

17d ago

Job
Full-time
Entry & Junior Level
People, HR & Administration
Healthcare

AI generated summary

You should have an associate's degree or equivalent experience, strong organizational skills, knowledge of Medicaid/insurance, and effective customer service. Must type well and sit/talk frequently.
You will coordinate patient services, manage referrals, verify insurance coverage, maintain patient records, communicate with families, and support clinical teams while ensuring compliance with regulations.

Requirements

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)

Responsibilities

- 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/leadership 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.

FAQs

What is the job title for this position?

The job title is Homecare Service / Referral Coordinator - Homecare Administration.

What type of schedule does this position have?

This position is a full-time schedule.

Where is the job location?

The job is located at 571 Longbow, Suite B, Maumee, OH 43537.

What are the main responsibilities of the Homecare Service / Referral Coordinator?

The main responsibilities include coordinating clinical services, verifying insurance coverage, managing patient information, scheduling services, and maintaining communication with patients, families, and third-party payors.

What educational background is required for this role?

An associate's degree in a medical-related field, office/business, or equivalent home health experience is required.

What skills are preferred for candidates applying to this position?

Preferred skills include knowledge of Medicaid and insurance regulations, strong organizational skills, attention to detail, and effective interpersonal and customer service skills.

What are the physical requirements for the job?

The physical requirements include constant sitting, talking on the phone or in person, and finger dexterity.

Is experience in home health care necessary for this job?

Equivalent home health experience is required, and knowledge of managed care is highly desirable.

Does the position involve communication with third-party payors?

Yes, the position involves communicating with third-party payors and case managers regarding patient coverage and home health benefits.

What is the commitment to diversity and inclusion at Nationwide Children’s Hospital?

Nationwide Children's Hospital integrates Diversity, Equity, and Inclusion into its core values and practices, seeking individuals who live these values and support their mission.

Nationwide Children's Hospital

At Nationwide Children’s, Everyone Matters. We have a purpose for every passion. Join our team.

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Mission & Purpose

Nationwide Children’s is one of America's largest pediatric hospitals, an international leader in research and is ranked in all 10 specialties on U.S. News & World Report’s 2023-24 “America’s Best Children’s Hospitals” list. Our staff, comprised of 1,500 medical professionals and over 13,000 employees, provides state-of-the-art pediatric care for 1.6 million patient visits annually. And, according to the Children’s Hospital Association, Nationwide Children's is the #1 provider of pediatric surgery in the country. As home to the Department of Pediatrics of The Ohio State University College of Medicine, Nationwide Children’s physicians train the next generation of pediatricians and pediatric specialists. The Abigail Wexner Research Institute at Nationwide Children’s Hospital is one of the Top 10 National Institutes of Health-funded freestanding pediatric research facilities. Nationwide Children’s remains true to the original mission since its founding in 1892 of providing care regardless of a family’s ability to pay. More information is available at NationwideChildrens.org. Our doctors represent every major pediatric sub-specialty. With over 50 locations throughout Ohio, signature programs include heart, cancer, gastroenterology and neonatology care, all of which are internationally recognized. Tim Robinson is CEO of Nationwide Children’s Hospital, which includes the Abigail Wexner Research Institute at Nationwide Children’s Hospital, Nationwide Children’s Hospital Foundation and The Center for Family Safety and Healing at Nationwide Children’s Hospital.