Job Description
Position Summary:
Within the framework of the agency program and policy has primary responsibility for accepting appropriate referrals for home health services and staffing those referrals with professional field personnel in accordance with physician's orders and authorizations for service by payer source. This process is coordinated by a system developed by the entire home health team.
Responsibilities
- Handle inquiry calls, confirm clinical appropriateness and payer eligibility.
- Runs Medicare/Medicaid eligibility on every referral.
- Verify staffing and resources before accepting referrals.
- Ensure proper staffing and review orders for authorized services.
- Collaborate with RN Coordinator on intake paperwork and care plans.
- Accurately enter client demographics and share details with caregivers.
- Attend clinical rounds and stay updated on payer contracts.
- Maintain effective communication with staff and referral sources.
- Track admissions, openings, and “not admitted” referrals for reporting.
- Support marketing efforts and resolve referral challenges.
- Maintain HIPAA compliance and confidentiality.
- Notify caregivers of resumed services and provide clerical support as needed.
- Perform other duties including community outreach and continuing education.