Compliance Coordinator - Home Care jobs in Richmond, VA

Our Company: Overview:

• Medical and dental benefits
• Short- and long-term disability
• Life insurance
• Paid time off
• 401(k) program
• Flexible Spending Account (FSA)
• Employee Assistance Program (EAP)
• Vendor discounts

Responsibilities:

• Coordinates all aspects of the patient intake process including establishing and maintaining positive relationships with customers and referral sources
• Completes the intake process from initial referral contact to hospice admission
• Ensures seamless transition of patients to hospice by providing direct oversight of patient education and preparation for home care, plan of care initiation, and coordination of care with multiple service providers
• Utilizes clinical knowledge to triage incoming referrals to determine necessity of timely initiation of care to include need for same day admissions
• Communicates directly with patients and families to ensure acceptance of services, responding to customer requests and concerns, and coordinating the insurance verification and authorization processes
• May be called upon to resolve complex customer service issues or requests from patients, physicians, family members, or referral sources
• Documents pertinent information regarding the patient’s demographics, medical condition, medications and treatments, and service being requested
• Consults with physicians, nurses, discharge planners, and other health care professionals to facilitate a safe and smooth transition to hospice by coordinating services and equipment needs for clients prior to their admission
• Uses clinical knowledge and knowledge of hospice criteria to anticipate patient needs and/or needs for orders for care
• Effectively communicates hospice criteria to referral sources and serve as a resource for hospice criteria and alternatives to internal and external customers
• Ensures face-to-face has been arranged if needed
• Ensures compliance with all state and federal referral and intake regulatory requirements.
• Reports problems of a clinical nature to the Director of Clinical Operations or Clinical Supervisor as appropriate
• Establishes and maintains positive working relationships with current and potential referral sources
• Initiates initial and ongoing insurance authorization
• Explains the Company’s policies, procedures, and programs to referral sources, patients and families
• Follows through on requests for marketing information
• Builds and monitors community and customer perceptions of the Company as a high quality provider of services
• Provides leadership in strategic planning including identifying opportunities for additional or improved services to meet unmet customer needs
• Maintains comprehensive working knowledge of the Company’s contractual relationships and ensure that patients are admitted according to contract provisions
• Maintains comprehensive working knowledge of community resources and assist referral sources in accessing community resources should services not be provided by the Company

Qualifications:

• Registered Nurse or Licensed Practical Nurse, with current and unencumbered appropriate state licensure
• At least two years of healthcare experience preferably in hospice operations
• Demonstrates a working knowledge of insurance reimbursement guidelines

About our Line of Business: At AT Home Care & Hospice, our primary ambition is to bring first-class care to the warmest and most serene environment possible: home. We provide the full spectrum of hospice and home health services, thoughtfully tailored to the individual needs of patients and families. As part of the BrightSpring Health Services family of brands, AT Home Care & Hospice is grounded in a foundational commitment to providing exceptional patient care and championing our agency leadership and teams. We are proud to have some of the best and brightest individuals in the health care industry on our team. We are confident you will find purpose, meaning and a chance to make a positive impact from day one. For more information about AT Home Care & Hospice, please visit www.athomecareandhospice.com. Follow us on Facebook.