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At Home Advisor

1 month ago

Neptune City, United States Hackensack Meridian Health Full time

Overview:
**At Hackensack Meridian **_Health_** at Home,** we recognize our **full

Qualifications:
Education, Knowledge, Skills and Abilities Required:

- High School diploma, general equivalency diploma (GED), and/or GED equivalent programs.
- Proficient in Google Space
- Strong Customer Service Skills

Education, Knowledge, Skills and Abilities Preferred:

- Home Care Experience
- One (1) or More Years Healthcare Experience
- Billing/Insurance Authorization Experience

**Responsibilities**:
Responsible for processing assigned Central Intake referrals. Responsible for procuring all incoming referrals and obtaining necessary documentation to support clean billing. Demonstrate optimum customer service skills. Perform authorization and verifications for identified product lines. Enter the required information into appropriate system accurately and assure clean claims for timely reimbursement.
- Answer incoming telephone calls. Monitor all referral management systems for new and referral updates on a continuous basis. Answer calls and questions utilizing excelling customer service skills. Assist with outside referrals if organization is unable to accommodate referral request. Network and build relationships with facility staff.
- Provide information to referral sources regarding programs and services available to meet customers needs. Answer all questions correctly and utilize intake resources when needed to assure information is correct.
- Screen calls for appropriateness. Demonstrate a clear understanding of the clients needs and priorities. Transfer calls to RN for orders. Enter accurate referrals from any At Home product line. Identify opportunities for cross selling and utilize them to assist patients by providing other services necessary to meet their needs.
- Demonstrate adherence to intake process for each referral from start to hand off to operations for scheduling. Meet productivity standards on a daily basis. Maintain an accurate account file following all intake processes. Drill down to root referral source to obtain primary referral information. Enter all information correctly and in detail for each patient. Obtain necessary documentation adhering to intake process. Obtain face-to-face (F2F) information and hand off to F2F team with appropriate information.
- Knowledgeable in current Medicare reimbursement criteria and insurance contracts for the organization product lines. Network with insurance payor case managers to assure ease of referrals for home care services utilizing customer service skills. Obtain all necessary documents on a consistent basis. Assure insurance verification and authorization is appropriate to assure clean billing and prompt payment.
- Verify member eligibility and ensure correct billing information. Contact benefit provider to gather policy benefits/limitations and ensure service provided will be reimbursed. Utilize shared drive for insurance contracts. Contact insurance companies to verify coverage and obtain authorization in a timely manner. Document all communications into appropriate software systems in a timely manner.
- Obtain and communicate all insurance needs assigned by supervisor to the appropriate operation. May also communicate with billing agencies for all changes, modifications or additions for client. Follow up with omitted communications or documents as assigned.
- Assure communication is timely and appropriate with all organization operations. Utilize tracking system to follow up on pending cases. Organize information, services resources and contracts. Problem solve with staff on any pertinent patient referral issues. Take ownership to assure that delivery of services meet customer and referral source expectations.
- Other duties and/or projects as assigned. Respond to needs of department by performing duties/tasks assigned to assure departmental functions are performed when staffing challenges are encountered and when team members need assistance as assigned by manager.
- Adheres to HMH's Organizational competencies and standards of behavior.
- Lifts a minimum of 10 lbs., pushes and pulls a minimum of 10 lbs. and stands a minimum of 2 hours a day.

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