Address
Form of work
SalaryThe staff is critical to the management of the client’s eligibility. A client’s eligibility and authorization for services are subject to change. The Intake Eligibility Coordinator should ensure that client eligibility and authorization are being systematically tracked, ensuring that authorizations are active and accurate information is being maintained in the CRM software. The individual should have knowledge of the home care eligibility regulations and have the skills to interact and get the best out of the clients.
RESPONSIBILITIES:
General functions
1. Monitor census daily and identify census with changes.
2. Monitor LTC Web and ePACES to ensure that client Medicaid is active and that clients are duly engaged to ensure that necessary actions are taken to reduce any gap in care.
3. Track authorization expiration and follow up with MLTC and HRA to obtain current authorization.
4. Follow up on any authorization denials/discrepancies.
5. Ensure all/any pre-billing issues are corrected.
6. Identify and bring to the attention of the nurses M27Ts that are outstanding, as this affects the ability to bill for service hours.
7. Work with finance to resolve authorization matters that might be causing billing rejections or conflicts.
8. Communicate changes in HRA cases to the Intake team, RNs, and CCs.
9. Ensure that MLTC and HRA are contacted to obtain permanent authorization.
10. Manage the tracking of M11Q and coordinate faxing/submitting of M11Q to the MCO.
11. Coordinate to ensure that HRA transfers to MLTC are managed adequately.
12. Any additional tasks as assigned by Intake Manager or DON.
13. Ensure effective communication with all relevant departments for various client matters.
14. Obtain pertinent information from new clients by asking them to complete surveys or interviews courteously and professionally.
15. Have the skills to learn multiple payors and state software systems (LTC Webs, HRA, etc.).
16. Generate weekly and monthly reports and maintain KPIs for the Intake Eligibility Function.
Standards of Performance
This job is not regarded as being satisfactorily performed unless, under normal circumstances, the following criteria are achieved.
● Strong interpersonal and communication skills
● Problem-solving attitude
● The ability to maintain confidentiality
● Ability to communicate well with customers, home care workers, and relevant coworkers
● Ability to relate well in cross-cultural environments
● Ability to manage multiple tasks, adopt to shifting priorities, and work well within the organizational structure
● Ability and willingness to travel locally to meet agency needsThe staff is critical to the management of client’s eligibility. A client’s eligibility and authorization for services are subject to change. The Intake Eligibility Coordinator should ensure that client eligibility and authorization are being systematically tracked, ensuring that authorizations are active and accurate information is being maintained in the CRM software. The individual should have knowledge of the home care eligibility regulations and have the skills to interact and get the best out the clients.
RESPONSIBILITIES:
General functions
1. Monitor census daily and identify census with changes.
2. Monitor LTC Web and ePACES to ensure that client Medicaid is active and that clients are duly engaged to ensure that necessary actions are taken to reduce any gap in care.
3. Track authorization expiration and follow up with MLTC and HRA to obtain current authorization.
4. Follow up on any authorization denials/discrepancies.
5. Ensure all/any pre-billing issues are corrected.
6. Identify and bring to the attention of the nurses M27Ts that are outstanding, as this affects the ability to bill for service hours.
7. Work with finance to resolve authorization matters that might be causing billing rejections or conflicts.
8. Communicate changes in HRA cases to the Intake team, RNs, and CCs.
9. Ensure that MLTC and HRA are contacted to obtain permanent authorization.
10. Manage the tracking of M11Q and coordinate faxing/submitting of M11Q to the MCO.
11. Coordinate to ensure that HRA transfers to MLTC are managed adequately.
12. Any additional tasks as assigned by Intake Manager or DON.
13. Ensure effective communication with all relevant departments for various client matters.
14. Obtain pertinent information from new clients by asking them to complete surveys or interviews courteously and professionally.
15. Have the skills to learn multiple payors and state software systems (LTC Webs, HRA, etc.).
16. Generate weekly and monthly reports and maintain KPIs for the Intake Eligibility Function.
Standards of Performance
This job is not regarded as being satisfactorily performed unless, under normal circumstances, the following criteria are achieved.
● Strong interpersonal and communication skills
● Problem-solving attitude
● The ability to maintain confidentiality
● Ability to communicate well with customers, home care workers, and relevant coworkers
● Ability to relate well in cross-cultural environments
● Ability to manage multiple tasks, adopt to shifting priorities, and work well within the organizational structure
● Ability and willingness to travel locally to meet agency needs
Job Type: Full-time
Pay: $45,000.00 - $50,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
Healthcare setting:
- Long term care
Medical specialties:
- Home Health
Schedule:
- 8 hour shift
- Day shift
- Monday to Friday
Ability to commute/relocate:
- Brooklyn, NY 11206: Reliably commute or planning to relocate before starting work (Required)
Education:
- Associate (Preferred)
Experience:
- Customer service: 1 year (Preferred)
- authorization process: 1 year (Preferred)
Language:
- Spanish (Required)
Work Location: In person
