Advanced Illness Management Administrator
2 weeks ago
About Illumia Health:
Illumia Health is a rapidly expanding division of Gentiva, a recognized leader in hospice and palliative care services.
Our clinical teams function as an extension of physicians' care, collaborating with them and other specialists to provide advanced illness management, a specialized form of high-touch palliative care aimed at alleviating symptoms and stress associated with illness while enhancing the quality of life for our patients, regardless of their location.
This adaptable and cooperative approach is delivered alongside curative treatments, serving as an additional layer of physical, emotional, and social support.As a cohesive team dedicated to bringing compassionate expertise to the unique journey of each patient, we take pride in celebrating each other's achievements within an inclusive environment that fosters generous support and rewarding career advancement.
Position Overview:
We are seeking a Care Coordinator for our Advanced Illness Management (AIM) Palliative Care program - a NON-CLINICAL ADMIN role to join our team.
This position will report directly to the Director of AIM and will be responsible for overseeing all daily business operations and other administrative activities related to the management of the advanced illness management (AIM) and palliative care department by performing the following duties personally, including intake, billing, medical record maintenance, and marketing functions.
Key Responsibilities:1. Oversee and manage all daily operational activities related to the administration of the AIM and palliative care department.
2. Process referrals by gathering necessary admission and insurance information to ensure timely and appropriate patient admissions.
3. Document the outcomes of calls either manually or through automated systems, conduct follow-up calls as needed, and identify/refer to alternative resources when applicable.
4. During business hours, reach out to the patient and family within 1 hour of referral to confirm receipt of referral information.
5. Maintain communication with pending patients, their families, and referral sources, and routinely track the progress of prospective patients and those referrals not taken under care (NTUC).
6. Coordinate and ensure effective scheduling for Nurse Practitioners, considering geographical factors that may impact time management and company costs.
7. Ensure appropriate reimbursement by identifying potential payer sources, verifying benefits with payers (as required by departmental structure), and obtaining initial authorizations if necessary.
8. Inform the AIM Team of patient acceptance of services and provide all relevant information, including accurate insurance and admission details, to ensure proper disclosure of rights, responsibilities, financial liabilities, and benefit plan specifics to patients and their families (if applicable).
9. Coordinate information for interdisciplinary team meetings and other essential meetings of the AIM Team.
10. Submit all necessary information from the site to the Billing Department for timely billing and collection of charges.
Collaborate with Billing Department staff on prompt responses to all billing denials, requests for additional information, and post-payment audits of submitted claims.
Establish and maintain professional and productive relationships with all referral sources, including the Gentiva family of companies.11. Serve as a resource for customers and the community regarding AIM, Palliative Care, and Hospice services.
12. Uphold a high standard of customer service, monitoring and tracking referral sources' satisfaction levels. Identify opportunities for additional or improved services to address unmet customer needs through family and physician satisfaction surveys. Communicate customer service issues to the Director as appropriate.
13. Participate, as applicable, in quality assurance and performance improvement activities for the AIM program, including necessary data collection and reporting.
14. Implement marketing and promotional initiatives as directed by the Director.
15. Adhere to and participate in the Company's mandatory HIPAA privacy program/practices, Business Ethics and Compliance programs/practices, and all Company policies and procedures, including the Employee handbook.
Qualifications:
High school diploma or equivalent required.
College degree preferred.
A minimum of three years of experience in healthcare delivery or related business experience is required; experience in a Part B billing setting is preferred.
Proficiency with computer applications and Electronic Medical Records.
Strong understanding of medical terminology and a focus on customer service.
Knowledge of the insurance reimbursement process.
Effective data entry, word processing, problem-solving, interpersonal, and oral/written communication skills.
Some travel may be required as requested.
What We Offer:
Comprehensive Benefits Package:
Health Insurance, 401k Plan, Tuition Reimbursement, Paid Time Off
Opportunity to participate in a Fleet Program
Competitive Salaries
Mileage Reimbursement
Professional growth and development opportunities
Legal Notice:
This is a safety-sensitive position.
Employees must meet minimum requirements to be eligible for benefits.
Where applicable, employees must meet state-specific requirements.
We are proud to be an Equal Employment Opportunity employer.
We maintain a drug-free workplace.
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