We are seeking an experienced Bilingual (Spanish/English) Home Care Intake Representative to manage the full intake and onboarding process for patients receiving MLTC, PCA, and CHHA home care services.
The ideal candidate will have prior home care intake experience and a strong understanding of Medicaid eligibility, MLTC plans, and home care workflows. Experience using ePACES, HHAeXchange (HHAX), and other home care software is required. This role requires excellent organizational, communication, and customer service skills to ensure a seamless intake and onboarding experience for patients, caregivers, and referral sources.
Responsibilities:
- Review and process referrals from MLTC plans, hospitals, physicians, patients, and families to determine eligibility for PCA/CHHA services, ensuring compliance with NYS Department of Health, Medicaid, and agency regulations.
- Verify Medicaid eligibility and coverage using ePACES, including CIN validation, plan enrollment, and service authorization requirements.
- Coordinate with MLTC care managers and insurance providers to obtain required authorizations, service plans, and documentation for timely case activation.
- Assist patients and families with scheduling and coordinating NYIA assessments to ensure timely completion of the enrollment and authorization process.
- Enter and manage patient data in HHAeXchange (HHAX) and internal EHR systems, including patient demographics, authorizations, updated notes, service hours, and intake documentation.
- Schedule initial nursing assessments and coordinate start of care, ensuring cases are opened within required timelines.
- Communicate with referral sources, MLTC plans, patients, and families to ensure all intake requirements are completed efficiently and accurately.
- Educate patients and families on available home care services, MLTC processes, and next steps for service initiation.
- Maintain accurate, audit-ready patient records, including intake documentation, eligibility verification, authorizations, NYIA status updates, and communication logs.
- Perform quality assurance checks on all intake files to ensure completeness, compliance, and readiness for billing.
- Collaborate with clinical, coordination, and billing teams to ensure seamless transition from intake to active services.
- Assist in optimizing intake workflows, improving turnaround times, and maintaining compliance with regulatory and payer requirements.
- Knowledge of Medicaid eligibility, code removals, Medicaid upgrades, and the Medicaid application process is a plus.
Required Skills:
- Effective organization and time management skills, like prioritization, multitasking and planning
- Great customer service skills, including a personable and positive attitude.
- High typing speed and accuracy
- Good computer skills, including basic troubleshooting and using word processing, spreadsheet, presentation and email software applications.
- Problem-solving, critical thinking and decision-making abilities
- Ability to work independently with little-to-no supervision.
- Keen attention to detail
- Team player
Pay range: $23 - $26 per hour
EQUAL EMPLOYMENT OPPORTUNITY
We are an equal opportunity employer. We do not discriminate based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran
status, genetic information, or any other protected characteristic under federal, state, or local law. Reasonable accommodation is available per ADA and applicable state laws.
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