Intake / Referral Specialist

  • Capital Health Home Care - Dayton
  • 275 Regency Ridge Drive
  • Posted: Apr 23, 2019

Job Description

Position requires applicant to be an LPN. (Licensed Practical Nurse)

Job Description Summary:

The Intake Specialist is responsible for managing all aspects of the patient intake process including maintaining ongoing communications with referral sources, establishing and maintaining positive relationships with customers, responding to customer requests and concerns, verifying home care coverage, and collecting and verifying insurance information and authorization for services.

Essential Job Functions/Responsibilities:

* Directs all daily patient referral and intake operations.
* Completes referral information that includes intake data, essential background information, hospital course, and the plan of care.
* Consults with physicians, nurses, social workers, discharge planners and other disciplines to establish a coordinated home plan of care.
* Coordinates, screens, and assesses home care needs of referrals in the areas of nursing, rehabilitation, psychosocial, and financial.
* Assesses insurance coverage or Medicare eligibility prior to admission.
* Ensures maximum third party reimbursement through direct oversight of insurance verification and authorization processes.
* Collaborates with physicians in determining patients’ home care needs.
* Ensures compliance with all state and federal referral/intake regulatory requirements.
* Assists with the implementation of improved work methods and procedures to ensure patients are admitted in accordance with policy.
* Participates in the quality improvement, utilization review, and long-range planning of the organization.
* Serves as a resource and consultant to field staff and management team.
* Exhibits good interpersonal relationship skills, written, and verbal communications.
* Attends multidisciplinary patient care conferences and staff meetings on regular basis.
* Assists with the development of intake policies, procedures, and protocols that adhere to Medicare, State and Federal regulations.
* Maintains comprehensive working knowledge of community resources and assists referral sources in accessing community resources should services not be provided by the Agency.
* Contacts LTC facilities as needed to inquire of potential referrals or family contact that may be needed.
* Contact case managers regarding potential referrals.
The above statements are intended to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

Position Qualifications:

* GED or high school equivalent.
* Knowledgeable in Federal and State governmental regulations governing home health agencies.
* Knowledgeable of resources available for the elderly.
* Able to make decisions, set priorities, evaluate patient needs, and keep accurate records.
* Knowledgeable of Medicare and third party home care reimbursement.
* Three years experience in home care preferred.
* Able to work independently and be flexible as to the daily needs of the agency.
* Strong written and verbal communications skills, including excellent telephone communication skills and customer service skills.