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SalaryOverview:
BENEFITS:
TABITHA’S PURPOSE: We empower people to live joyfully, age gratefully.
Responsibilities: POSITION SUMMARY:
The Scheduling and Insurance Specialist is responsible for scheduling patient visits in the home health department and collaborating with Clinical Managers and clinicians to assure visits are covered. This position is also responsible for obtaining payer eligibility, initial and ongoing authorization for home health and hospice patients and may support the Continuum Navigation members with phone triage and intake tasks when working in the department. This TEAMember strives to uphold Tabitha’s LIVE2Care Culture actively embraces Tabitha’s Core Values. As a result, the TEAMember supports Tabitha goals related to dignity, respect, independence, competence, autonomy, personal comfort, safety and security of seniors/clients. In addition, the TEAMember contributes to the success of Tabitha through ongoing collaboration with TEAMembers, management, volunteers and others in the organization.
ESSENTIAL FUNCTIONS:
- Schedules visits matching TEAMembers to Senior/client appropriately, considering skill, needs, continuity of care, availability, volume of hours and location.
- Follows the master schedule developed by the clinical manager to staff the agency and schedule all clinicians, including regional scheduling.
- Updates availability of staff in the Electronic Medical Record (EMR)
- Schedules on holidays/weekends
- Monitors clinician hours to support productivity expectations
- Follows the master schedule developed by the clinical manager to staff the agency and schedule all clinicians, including regional scheduling.
- Proactively communicates with field TEAMembers to schedule visits and make adjustments that enhance Senior/client outcomes and satisfaction.
- Covers scheduled and unscheduled leave of absences for TEAMembers, adhering to department and/or agency policies and procedures.
- Collaborates with Continuum Navigation to assure referrals are accepted and scheduled timely.
- Schedules nursing students and communicates with TEAMembers to fulfill the community experience for the student.
- Utilizes the EMR to create schedules, monitor TEAMember availability and verification of hours worked. Maintains documentation in the EMR of cancels, reassigns, declines, and missed visit and follows agency procedure.
- Receives telephone calls, directs calls to the appropriate staff person and provides general information to meet their needs.
- Completes basic intake and referral tasks entering basic information on hospice and home health referrals.
- Verifies benefits and eligibility for Seniors/clients in home health and hospice business lines for Medicare, Medicaid, Medicare Advantage, VA and commercial insurance.
- Obtains initial and ongoing authorization for services. Monitors and tracks usage of authorization and maintains accurate documentation in the EMR.
- Proactively communicates with TEAMembers regarding authorization needs, discharge planning, and requests for additional information and/or denial of services.
- Collaborates with Intake staff and home health and hospice leadership when there are issues identified in the benefits/eligibility/authorization process.
- Willingly takes on additional duties and/or assignments, assisting with projects and responding to requests as assigned or as necessary.
BENEFITS:
- Full benefit package including medical, dental and vision (30+ hours per week scheduled)
- Life and disability benefits (30+ hours per week scheduled)
- Paid Time Off, Paid Holidays and Paid Leaves (20+ hours per week scheduled)
- Free on-site TEAMember clinic
- Wellness program
COMMUNICATION: Must be able to speak, read, write, and understand the English language as well as terminology and jargon specific to the job. Sufficient fluency to be able to understand and follow written and verbal instructions, provide instructions to others, read and understand policies, procedures or other similar documentation, interact successfully with seniors/clients/caregivers, hold a conversation, conduct or participate in meetings, compose professional e-mails or other written communication, prepare legible, accurate and thorough documentation as required by the job and effectively interact with TEAMembers, customers, vendors, volunteers, managers and family members. Ability to use accounting practices, principles, and procedures. Ability to use mathematical calculations, including: fractions, decimals, percentages, algebraic calculations, and descriptive statistics. Ability to recognize and interpret non-verbal cues. Ability to respond calmly and clearly to emergencies and emotional situations.
PHYSICAL REQUIREMENTS: Ability to gain access to the work area and then safely perform the duties of the job while utilizing standard and specialized equipment, including but not limited to the equipment described below. Ability to move about the work area. Ability to do sedentary work at a computer for hours at a time. Frequent periods of intense activity occasional need for physical strength or physical exertion. (Occasionally lifting/carrying a box of records for example) Must have the ability to spot errors or to sense when data output contains an error. Vision and hearing within normal limits (with or without correction) Must have unrestricted lift/push/pull ability and pass a 25 - pound physical exam demonstrating strength and agility prior to employment and from time to time thereafter at Tabitha’s discretion.
AGE REQUIREMENT: At least age 18.
EDUCATION: High school diploma or equivalent required.
EXPERIENCE: Experience in health care field preferred, knowledge of insurance and billing preferred. Supervisory experience preferred. Scheduling experience preferred.
CREDENTIALS: Must meet Tabitha’s vaccination requirements.
PHYSICAL REQUIREMENTS: Ability to gain access to the work area and then safely perform the duties of the job while utilizing standard and specialized equipment, including but not limited to the equipment described below. Ability to move about the work area. Ability to do sedentary work at a computer for hours at a time. Frequent periods of intense activity occasional need for physical strength or physical exertion. (Occasionally lifting/carrying a box of records for example) Must have the ability to spot errors or to sense when data output contains an error. Vision and hearing within normal limits (with or without correction) Must have unrestricted lift/push/pull ability and pass a 25 - pound physical exam demonstrating strength and agility prior to employment and from time to time thereafter at Tabitha’s discretion.
AGE REQUIREMENT: At least age 18.
EDUCATION: High school diploma or equivalent required.
EXPERIENCE: Experience in health care field preferred, knowledge of insurance and billing preferred. Supervisory experience preferred. Scheduling experience preferred.
CREDENTIALS: Must meet Tabitha’s vaccination requirements.
EEO Veteran/Disability
