Central Intake Coordinator
Job Overview
Duties and Responsibilities
MUST LIVE IN CST or EST TIME ZONES
- Organization Communication
- Handles all daily patient referrals and intake operations, reviews, and processes pending referrals
- Enters all demographic and insurance information for new customers and updates as needed
- Completes registration of clients into the home care management program in an accurate and timely manner
- Informs location staff of received referral/s with full details on deductible, coinsurance, and copay
- Adheres to the rules regarding confidentiality of HIPAA protected health information
- Assists with the identification and reporting of potential quality management and noncoverage issues
- Communicates with relevant parties to obtain authorization of home health services, initial and ongoing Interfaces with providers/office staff/clinical staff/caregivers for the purpose of attaining additional information required for authorization approval
- Provides direct support regarding utilization, authorization, and referral activities
- Contacts providers and families with authorization, denial, and appeals process information
- Completes monthly authorization expiry reports and informs location of upcoming renewals
- Completes all changes to health insurance in KanTime
- Verification
- Verifies eligibility of members and member benefit coverage at initial start of care and ongoing eligibility and benefits verification on the 1st and 15th of each month
- Reports all discrepancies to the Director of Clinical Services, Director of Therapy, Account Manager, and Director of Central Intake
- Insurance knowledge experience
- General knowledge of state Medicaid plans, private insurance plans, Medicare and Veteran Affairs
- Performs all other duties assigned by Director of Central Intake
- Supports and executes the mission, ethics, and goals of the company effectively
- Represents themselves in a positive and professional manner in the company and community
- Adheres to dress code with a clean and neat professional appearance
- Reports on time and as scheduled to complete work within designated time
- Adhere to all company policies and procedures outlined in Employee Handbook, Employee Agreement, or communicated from executive team
Requirements
- High School Education- Associates Degree preferred
- Exceptional Customer Service
- Must be detailed oriented
- Familiarity with ICD-10 coding
- Able to work independently
- Able to work remotely
- Ability to perform basic to intermediate applications with Excel
- Strong verbal and written communication skills (Additional languages preferred)
- 1+ year experience in a clinical environment preferred
- Requires in depth knowledge of benefits and authorizations
- Proficient use of standard computer programs for data entry and data organization
Additional Job Description Information
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EEO Statement:
MGA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other status protected by applicable law.