Job Summary:
We are seeking a detail-oriented individual to join our team.
- Manage all aspects of service preauthorization and reauthorization for all Veterans Affairs and Medicaid members
- Act as the lead for all aspects of documentation and compliance related to private pay, Veterans Affairs and Medicaid members, and keep them audit ready at all times
- Coordinate scheduling of RNs in a prompt and timely manner
- Coordinates and collects RN paperwork, supporting documents, prints, distributes as necessary, and maintains logs
- Manage complaints, maintain documentation and escalate to the supervisor
- Resolves and escalates issues, offers solutions and make recommendations for management to choose from
- Oversee the maintenance, analysis and security of paper and electronic files of all members in a confidential, organized, current and retrievable manner while maintaining them audit ready in accordance with the State, Federal, DOL, Homeland Security, OSHA, Veterans Affairs, VDH, DMAS, Medicaid and MCOs criteria and standards
- Populate and trouble-shoot home care management and scheduling system
- Assist in providing print materials for staff and contractors working for members
- Provides reports and data regarding referrals, admissions, discharges, ongoing census, hour utilization, discrepancies, missed visits and other business processes in a quantifiable, meaningful manner so as to optimize data utilization
- Maintains member files and office records for governmental compliance, audit readiness, and also participates in the audit process
- Coordinate changes of status, names, addresses, contact information etc. of members in their physical and electronic files and on the computer software
- Maintain mail log, complaint log, ship mail and other official correspondence and keeps record of such
- Manage phone calls and coordinate messages to all concerned. Manage situations during off hour remotely on on-call basis. Make member satisfaction calls
- Develops and updates Standard Operating Procedures (SOAP) for all business processes according to the following four payer categories: private pay, Medicaid, long-term insurance and Veterans Affairs.
Experience:
- Previous experience working in Medicaid enviornment highly desired
- Remain approachable and coachable and exhibit friendly demeanor.
- Experience with scheduling software such as AxisCare is advantageous
- Previous experience in administrative support preferred
- Ability to work in a fast-paced environment, prioritize tasks, and multitask effectively
- Strong communication skills, phone etiquette and customer service orientation
Join our team and enjoy the opportunity to contribute to a dynamic healthcare environment while utilizing your scheduling expertise.
Job Types: Full-time, Part-time
Pay: From $23.00 per hour
Benefits:
Application Question(s):
- How many years of care coordinator experience do you have?
Experience:
- Medicaid: 1 year (Preferred)
Work Location: In person
