Referral Specialist

Reports To: Home Health Operations Manager

JOB DESCRIPTION SUMMARY

Responsible for all aspects of the patient intake process which includes accepting home health referrals, scrubbing them for PDGM acceptable codes, securing initial authorization for services, validating insurance as well as coordinating the patient needs and schedule with an assignment of a clinician to start the admission process. Must work effectively with customers and referral sources, responding to customer requests and concerns.

ESSENTIAL JOB FUNCTIONS/RESPONSIBILITIES

1. Processes all daily patient referral and intake operations including compliance with the established intake policies.

2. Ensures compliance with all state, federal, and ACHC referral/intake regulatory requirements.

3. Establishes and maintains positive working relationships with current and potential referral sources.

4. Ensures seamless transition of patients to home care by providing direct oversight of patient education and preparation for home care, plan of care initiation, and coordination of care with multiple service providers.

5. Ensures maximum third party reimbursement through direct oversight of insurance verification and authorization processes.

6. Maintains comprehensive working knowledge of Dependable Health Services. contractual relationships and ensures that patients are admitted according to contract provisions.

7. Maintains comprehensive working knowledge of community resources and assists referral sources in accessing community resources should services not be provided by Dependable Health Services

The above statements are intended to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

POSITION QUALIFICATIONS

1. At least three (3) to five (5) years’ experience in home health or hospice.

2. Demonstrates good communication and public relations skills.

3. Demonstrates autonomy, organization, assertiveness, flexibility and cooperation in performing job responsibilities.

4. Bilingual preferred.

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