Benefits Coordinator - Healthcare jobs in Oklahoma City, OK

Overview

Job Summary: Responsible for managing all aspects of the client intake process including managing the members of the intake team, establishing, and maintaining positive relationships with customers and referral sources, responding to customer requests and concerns, and managing the insurance verification and authorization processes.

Responsibilities

Job Duties:

• Directs daily referral and intake operations including providing direct oversight of the establishment and implementation of intake
• Ensures compliance with State, Federal, and other referral/intake regulatory
• Directs the implementation of improved work methods and procedures to ensure clients are admitted in accordance with
• Establishes and maintains positive working relationships with current and potential referral
• Ensures maximum third-party reimbursement through insurance verification and authorization
• Assists in negotiations for service pricing with insurance Case Managers and other payers within established financial and credit
• Builds and monitors community and customer perceptions of HOME LIFE HEALTHCARE, CORP. as a high-quality provider of
• Gathers, collates, and reports referral statistics including key customer referral
• Maintains comprehensive working knowledge of HOME LIFE HEALTHCARE, CORP. contractual relationships and ensures that clients are admitted according to contract provisions.
• Maintains comprehensive working knowledge of community resources and assists referral sources in accessing community resources should services not be provided by HOME LIFE HEALTHCARE,
• Handles all telephone calls regarding scheduling and coordination of service delivery personnel to meet client scheduling
• Accepts assignments from the Director of Nursing or Chief Clinical Officer
• Schedules personnel
• Contacts individuals’ assignments and scheduling
• Receives a comprehensive "report" of staffing and service activity from the on-call coordinator
• Coordinates client requests for service
• Accurately schedules clinician in EMR (Kinnser) as needed and notifies clients regarding the status of their services
• Assists in determining client needs and provides general information regarding services
• Coordinates personnel scheduling requests as needed
• Accurately records employee availability and coordinates availability with service requests
• Notifies personnel in a timely fashion if the client cancels a request. Makes every attempt to reschedule agency personnel on another assignment
• Contacts personnel, as needed, to request availability to work
• Maintains an accurate telephone log of all communications with agency personnel and referral sources

• Consults with the case manager or supervisor for any of the following:
• Clients needing initial or emergency assessments
• Inability to staff a client
• Client complaints unable to be resolved
• Service delivery personnel complaints or issues unable to be resolved
• Clinical issues or problems needing the attention of a nurse
• Provides "on-call report" to the supervisor each evening
• Reports status of assignments given by the supervisor that day
• Reports service requests received during office hours and the status of the requests
• Reports information received from or about personnel including:
• Availability received (dates, times, )
• Changes in personnel status (active, inactive, part-time, )
• Changes in personnel addresses, phone numbers,
• Problems in scheduling or actions requiring disciplinary action
• Any other information which might be useful to the supervisor in providing quality services to clients
• Benefits and Authorization
• Verifies third party reimbursement coverage
• Follows up on pending unresolved coverage issues
• Obtaining initial authorization from payer sources to begin services
• Obtains authorization from insurance companies and keep tracks of any pending authorizations and overdue
• Assisting with resolving insurance issues, reauthorization, and eligibility issues.
• Verifying eligibility on a continues basis with all insurance carriers
• Communication payer verification or benefits issues
• Facilitating follow-up with payer staff/case managers regarding ongoing services, eligibility and authorization
• Responsible for completing all mandatory and regulatory training programs
• Perform other duties as assigned

Qualifications

Required Training:

• HIPPA Privacy Course
• HIPPA Security Course

 Job Skill Requirements:

• Complies with accepted professional standards and practice
• Two years’ experience in intake/ scheduling position, preferably in private duty or home health
• Has an ability to market aggressively and deal tactfully with vendors and referral sources
• Has knowledge of corporate business management, governmental regulations, and private payer practices.
• Demonstrates good communications skills, negotiation skills, and public relations
• Demonstrates autonomy, organization, assertiveness, and flexibility and cooperation in performing job
• Is self-directed with the ability to work with little
• Has excellent coordination and communication skills.

Management Skills Required:

• Customer Service: Must provide timely and accurate responses to all business associates and customers
• Planning: Must develop effective plans, objectives and goals that achieve desired results in a timely manner
• Organization: Must organize work in a systematic way, establish clear lines of responsibility, and delegate effectively
• Communication: Must write and speak clearly and effectively at all levels, listen and be attentive to others
• Decision Making: Analyze data and make and/or implement effective decisions in a timely manner
• Technology: Must use technology to its fullest potential to achieve department and corporate goals

Leadership Skills Required:

• Leadership: Gains acceptance of ideas and accomplishes goals through subordinates, peers and teams
• Personnel Development: Selects, trains, coaches and develops associates and teams for peak performance
• Teamwork: Must strengthen team performance by sharing information, establishing guidelines and celebrating success
• Empowerment: Demonstrates positive and active ownership of one’s responsibilities and fosters the same in others
• Employee Relations: Provides and solicits constructive feedback, evaluates performance and takes corrective action

Behavioral Traits:

• Intuitive/Open minded: Must be able to see opportunities, develop and implement creative solutions to complex problems
• Achievement Drive/Commitment: Driven to achieve goals, objectives and results. Fosters a culture of continuous improvement
• Positive/Supportive: Inspires and shows faith in others, builds a positive and supportive work environment
• Flexibility: Ability to adapt to changing business needs. To balance multiple priorities and deliver under pressure

Educational Requirements:

• Associates Degree

Experience:

• At least 2 years experience in Home Health or similar field.

Special Conditions of Employment:

• Criminal background check and/or drug test
• Initial and continuous exclusion and sanction/disciplinary monitoring