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Form of workJob Description
MGA Homecare has been providing Private Duty Nursing, Skilled Nursing Visits, Occupational Therapy, Physical Therapy, and Speech Therapy services within the home and community-based setting for over a decade. In 2022 MGA has opened its doors to MGA Behavior Therapy which offers Applied Behavior Analysis (ABA) and early behavior intervention for pediatric patients with autism spectrum disorder (ASD) and other developmental disabilities.
We aim to help our patients and their families by delivering high-quality clinical care in the comfort of their homes. Our goal is to make the lives of our patients and their families easier by demonstrating compassion and integrity at the heart of everything we do. By bringing individualized attention and support throughout every home. MGA Homecare is proudly serving the states of Arizona, Colorado, North Carolina, Tennessee, Texas, and Washington, and are here to be a resource for patients and their families.
Reports directly to the Sr. Director of Central Intake and is responsible for completing referrals using gathered information to provide data necessary to coordinate service eligibility, insurance verification, authorization and care coordination, handles requests for facilitating problem-solving of referral source information specific to coordination of patient admissions, and ensures maximum third-party reimbursement through monitoring insurance verification and authorization process. This position also communicates with provider/clinical staff/caregivers as necessary to obtain pertinent information and acts as the point of contact, aiding providers and organization.
- Organization Communication
- Handles all daily patient referrals and intake operations and 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 non-coverage 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 any and 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
- High School Education- Associates Degree preferred
- Must have insurance experience
- Home health experience preferred but not required
- 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 Information
Benefits are available to eligible employees on the first of the month after 30 days of employment and include:
- Compensation includes: $18 - $20/hr
- Health, Dental & Vision Coverage
- Health Savings Accounts (HSA-available if enrolled in high deductible plan)
- Flexible Spending Accounts (FSA & LPFSA)
- Dependent Care Reimbursement Accounts (DCRA)
- Employee Assistance Program (EAP-available if enrolled in Health plan)
- 401(k) retirement plan
- Paid Time Off (PTO)
- 100% Company Paid Basic Life Insurance (if enrolled in Health plan)
- Voluntary Life Insurance
- Short & Long-Term Disability
- Critical Illness/Accident Insurance
- Hospital Indemnity Insurance
- Identity Protection Plan
- Legal Care Plan
- Pet Discount Program
All your information will be kept confidential according to EEO guidelines.
#IND123
At MGA, we prioritize diversity, equity, and inclusion (DEI) in both our organization and the communities we serve. We understand that DEI is crucial to our success as a healthcare company, allowing us to provide personalized care tailored to each patient's unique needs and preferences. Our belief is that everyone, regardless of their background or identity, deserves access to high-quality healthcare services. We respect and value the experiences, perspectives, and identities of all individuals, striving to create an environment where everyone can thrive. We are dedicated to attracting, developing, and retaining a diverse workforce that reflects the communities we serve, without discrimination based on race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
