Mental Health Care Planner

Job Description

Job Description

Essential Duties and Responsibilities

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position.

• Obtains patient demographic and health insurance information : collects co-pay(s) when appropriate.
• Verifies and records insurance benefits, with the ability to understand and provide insurance breakdowns.
• Obtains prior authorization if required by payer(s).
• Interacts professionally with LCSW's, Case Managers, RT’s, PCC’s, Viemed Staff, patients, patient's family, and co-workers.
• Schedules referral appointments, as called into VCS, by LCSW's, per policy and procedure.
• Retrieves incoming referral(s) and logs demographic information into current patient database & billing system.
• Assigns patients to case managers and social workers according to nee
• Reviews medical records from referral(s) to determine if medical necessity has been met.
• Communicates to administrative staff& / or referral source(s), if referral is acceptable or what is missing to complete referral(s).
• Documents in computer system the status of referral.
• Reports all concerns or issues directly to VCS Manager, Supervisor, Lead, or VCS Planner
• Creates Smartsheet and Excel reports to track referrals, SW / CM task completions.
• Maintains credentialing of VCS program with Behavioral Health Insurance Companies including applying for company credentialing, LCSW individual credentialing, managing Smartsheet to track when licensures are for renewal and addressing any communications sent by the Insurance companies.
• Other responsibilities and projects as assigned.

Qualifications

Access to Protected Health Information (PHI)

This position will require the employee to handle Protected Health Information (PHI) for duties related to document and report preparation. Policies and procedures will be strictly adhered to make sure PHI is protected as required by the HIPAA Privacy Rule.

Working Conditions

This position will work in an office environment.

You will be expected to work during normal business hours, which are Monday through Friday, 8 : 00 a.m. — 5 : 00 p,m. Please note this job description is not designed to cover and / or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties and responsibilities may change at any time with or without notice.