This is a Part Time Role - preferably 3 days a week Monday, Tuesday and Friday, but open to Adjustment.This is a Hybrid Work OpportunityWHY YOU SHOULD JOIN PROHEALTH:PROHealth Home Care Services was founded with the ultimate goal of providing quality, personalized home health care services to patients across the Los Angeles area, and have earned an Excellent Industry Reputation. We are uniquely qualified to provide the level of nursing care and home health services that offer patients the greatest opportunity at recovering and regaining independence.At PROHealth Home Care Services, we have a Commitment to Excellence by creating an environment of teamwork and participation that fosters High-Quality diagnosis, treatment, and recovery. Our home health care professionals work closely with their patients’ physicians to promote their health and safety. PROHealth is dedicated to ongoing training and education to remain at the cutting edge of in-home health care.We are a quickly growing company with exciting and rewarding career opportunities. PROHealth’s strong team-oriented culture encourages professional growth and development. Employees are the Company’s Most Valuable Asset. PROHealth seeks to create a workplace that attracts top talent and retains employees with a culture of diversity and inclusion. They foster a collaborative and respectful work environment where all employees can make a difference.We are proud to offer a highly Competitive Total Rewards Package for our Full-time employees. This position includes Competitive Compensation, a comprehensive benefits package including medical/dental/vision insurance, and an accumulated 15 Days of Paid Time Off per year plus 10 Holidays.GENERAL SUMMARY

The Referral (Intake) Specialist will serve as the primary customer service contact within Intake. This individual will assist the Clinical Supervisor in ensuring the effective communication between Intake staff and referring physicians, acute care hospitals, skilled nursing facilities, patients, families, Agency staff, Liaisons, and other referral sources. Utilizes and promotes use of excellent customer service skills when working with internal and external customer service sources in an office setting.

PRINCIPAL DUTIES AND RESPONSIBILITIES (Included but not limited to):

Provides the primary referral and inquiry customer service presence for the Agency’s services.

Manages all incoming calls to Intake and ensures a response on or before the third ring.

Initiates referral documentation of a predetermined set of data elements in the EMR from all referral sources and assigns to the appropriate next person in the referral management process.

Establishes positive relationships with payer verification/authorization sources.

Ensures that consistent and timely initial communication regarding referrals occurs within Intake and with all Agency offices or service lines.

Verifies insurance and eligibility of benefits per established procedures and processes.

Obtains authorizations for follow up care/services per established procedure and processes as indicated.

Accurately records and data enters insurance/authorization information per EMR requirements.

Continually monitors payer verification/authorizations needed/requested/expiring and notifies appropriate personnel based on established procedure and process.

Works closely with the Team Assistants to facilitate scheduling of authorized visits only.

Supports/collaborates with the Case Managers in ensuring the accuracy of needed information to request authorization for appropriate patient care services.

Collaborates and communicates with the Revenue Cycle Manager to maintain updated information regarding payer contracts and related requirements affecting verification/authorization.

Assists the Revenue Cycle Manager in problem solving payer verification/authorization-related collection issues.

Appropriately utilizes Director for outliers, problems or difficulties.

Demonstrates knowledge of and consistent application at all times of patient rights to confidentiality.

Demonstrates a high degree of commitment to customer service and quality care provision.

Applies effective, respectful and positive verbal and written communication methods in the daily work setting to promote a collaborative work environment.

EDUCATION and EXPERIENCE:

High school diploma or equivalent with successful completed course work or equivalent experience in medical terminology and/or working in a healthcare environment.

Minimum of one year experience working in a health care environment preferred. Customer service background via telephonic communications required. Proven customer relations and phone etiquette abilities required.