Builds relationships, receives referrals and reviews patient information referred to VNSNY Home Care program to determine initial appropriateness of admission. Promotes and fosters ongoing collaborative communication with institutional and VNSNY personnel to establish coordinated home care. Facilitates the safe and timely transfer of patients from a hospital, skilled nursing facility, or other Health Care site to the care of VNSNY. Works under moderate supervision.
Responsibilities
Reviews patient information referred to VNSNY Home Care to determine initial appropriateness for admission and recommends acceptance or rejection of patients basedon Agency’s admission criteria. Collaborates with onsite HCC or Clinical Intake Manager as needed. Obtains patient insurance and payment information from various sources, and submits requested information to Revenue Cycle Department (RCD) for home care authorization. Verifies insurance information and coordinates acceptance of cases with Managed Care. Informs patients/family member of sources(s) and extent of coverage. Interprets reimbursement and coverage issues to hospital staff and patients and determines appropriate charitable care fund utilization. Meets with the patient and/or family, and advocates for VNSNY’s home care services. Interviews patient/family and confirms demographicsand other information (i.e. discharge date, medications, allergies etc.). Provides patient and family members with information as to how to contact VNSNY between time of hospital discharge and initial home visit.Compiles patient demographic information using medical records, medical database, patient interviews, hospital staff and other sources, for all types of cases, and works with VNSNY team members to ensure a safe initial discharge home. Recommends an initial home plan of care (POC) for appropriate patients, using established protocols and standards. Collaborates with regional operations management and VNSNY nursing staff to ensure that the Agency is ready to meet patients’ needs at the time of discharge. With RN, assesses appropriateness of requested services, medical supplies and DME, to ensure optimal patient outcomes. Confirms that appropriate supplies and/or medical equipment are readily available in patients’ homes prior to dischargeEstablishes and promotes an ongoing collaborative relationship between the Agency and/or other facilities, direct care givers, physicians, nurses, discharge planners, case managers, social workers, etc. to ensure coordination of appropriate referrals.Determines customer needs and provides accurate and responsive intake to ensure customer satisfaction. Provides appropriate handoff of information to team members to support a safe and effective discharge for the patient.Requests appropriate referrals from customers.Represents VNSNY at institution and community programs and functions. Markets VNSNY programs/services by providing information through promotions, lectures, health fairs, etc.Provides educational resources to the institution concerning appropriate home care services, and community resources. Interprets governmental regulations regarding home health care.Participates with the implementation of clinical initiatives or pilot projects within assigned accounts.Participates in the orientation of new Intake and other Agency staff as requested. Participates in regional team meetings as needed.Assumes responsibility for professional growth to optimize skills.Participates in special projects and performs other duties, as required.
Qualifications
Education: Bachelor’s Degree in Health Care, Business or a related field or the equivalent work experience required.
Experience: Minimum of two years of customer service experience in the medical field (i.e. hospital, long term care, home care setting, or medical office) required. Ability to understand medical terminology required. Experience entering data, navigating and retrieving information through a mainframe or similar computer system required. Ability to adapt to change and work in a team based environment required. Demonstrated ability to be persuasive, negotiate to win-win outcomes and provide exceptional customer service required. Demonstrated capability to gain commitment, build rapport with others (patients, families, physicians, clinicians, institutions etc.) required. Strong follow up skills, as well as the ability to manage multiple priorities, required. Knowledge of managed care, Medicare/Medicaid and insurance authorization/billing preferred. Bilingual skills may be required, as determined by operational needs.