Central Intake Coordinator

Essential Functions Statement(s)

• Review and process referrals and documentation from hospitals, physicians, patients, or families to determine eligibility and need for home health services, ensuring compliance with federal, state, and agency regulations.
• Verifying the ordering Physician’s license through the Louisiana Medical State Board of Examiners Office and PECOS enrollment.
• Obtaining a verbal and/or written order for services from the authorized healthcare provider
• Gets clarification and/or more details as needed for initial orders
• Initiates the Electronic Medical Record at time of referral to include entering patient basic information as well as verifying completion of documentation:Creates a chart for the patient in the agency’s EMR and inputs patient and referral information.
• Notifies the Clinical Manager or designee of the referral and sends all referral information and correspondence to the Clinical Manager or designee to review and determine acceptance.
• Coordinate with healthcare professionals to obtain patient medical history, documentation, insurance information, and physician information necessary for admission and billing purposes.
• Educate patients and families about home health services, care plans, and the roles of various healthcare professionals involved in their care.
• Facilitate communication between patients, families, and the home health care team to ensure coordination of services and adherence to the care plan.
• Assist in the development and implementation of intake policies and procedures to improve efficiency and effectiveness of service delivery.
• Functions as the primary point of contact for incoming patient referrals/prospects and for all medical record retrieval and processing between the office, team members, facilities, referral sources and physicians.
• Facilitates a face-to-face encounter between the patient/family and staff as needed (informational, admission, how can we help, etc.).
• Demonstrates professional and courteous communication skills when interacting with the internal teams as well as outside agencies.
• Demonstrates knowledge of eligibility criteria and the data needed to complete a thorough medical records review.
• Completes benefits check to verify coverage for Home Health services as well as the benefit period patient is entering; completes pre-authorization requests if required by insurance payers and obtains initial authorization for home health services.
• Communicates with the Sales and Clinical Teams regarding the status of the referral through verbal and written communication utilizing the referral spreadsheet and email.
• Updates and maintains referral spreadsheet with current information.
• Assists with other duties as assigned when not fulfilling primary responsibility, as directed by the supervising manager.

Skills & Abilities

• Excellent verbal and written communication skills.
• Excellent interpersonal skills with the ability to manage sensitive and confidential situations with tact, professionalism, and diplomacy.
• Excellent organizational skills and attention to detail.
• Proactive and independent with the ability to take initiative.
• Adheres to Allegiance Policies and Procedures. Refers to manual when not familiar with policies and procedures. Clarifies with manager deviation from stated policies and procedures, and informs manager of alterations or errors in carrying out policies and procedures.
• Contributes to a working environment that encourages collaboration and communication between all members of the clinical team and the community relations team.
• Demonstrates accountability for own decisions and actions.
• Ability to prioritize tasks, manage multiple priorities, and work effectively in a fast-paced environment.
• Proven experience in intake coordination, care management, or a similar role within the home care or healthcare industry.
• Proficient with Microsoft Office Suite and Google Suite or related software.
• Keen eye for detail and ability to interpret complex medical information
• Proficient with medical terminology, conditions, and treatment to effectively communicate with healthcare providers, clinical staff, and patients.
• Holds and maintains knowledge of eligibility criteria and the data needed to complete a thorough medical records review.
• Ability to coordinate care with patients and healthcare providers to ensure the patient's needs are met with the appropriate home health services.
• Holds and maintains knowledge to ensure patient records, referrals, insurance authorizations, and other related documentation comply with federal, state, and agency regulations.
• Holds and maintains knowledge of HIPAA regulations to protect the confidentiality and security of patient information.
• Strong understanding of home care services, caregiving practices, and relevant regulations.

Education & Experience

• Associate or Bachelor’s degree in Nursing or a related field preferred
• One to two years of medical office insurance experience required

Certificates & Licenses

• Valid driver’s license
• Current automobile insurance

Work Environment

• Work will be mostly indoors, with frequent to occasional outdoor requirements. Adequate lighting and ventilation are provided in work areas.
• Sits, stands, bends, and moves intermittently during working hours.
• Subject to interruptions.
• May encounter hostile and emotionally upset individuals through communication and involvement with residents, family members, staff members, visitors, and the public.