LPN Central Intake Home Health

Newport News, Virginia

Overview

Performs intake, insurance verification and preauthorization, and processing of all referrals for service lines within the Home Care Division. Elements required for above include data collection and clinical review of all referrals, determination of referral acceptance based on established criteria, attaining and remaining knowledgeable and current related to Medicare / Insurance reimbursement information and regulations, knowledge of service lines and products, and coordination of services. Provides exceptional customer service to all contacts by telephone, in person and via electronic media.

What You Will Do

• Performs clinical review of data collected, accurately determines appropriateness and acceptance of referrals based on established criteria, coordinates services and dissemination of information. Facilitates transfer of referral to other agency for declined referrals. Performs any follow up and continues communication with all parties until referral is complete and / or services are provided or cancelled.
• Uses clinical knowledge to collect complete and appropriate data for referrals, and fields phone calls utilizing the Care Difference principles. Serves as an information resource for all applicable services including contact information, coverage criteria, availability of services and alternatives to applicable services when appropriate.
• Responsible for data maintenance and integrity, entering and retrieving data from various computer systems and recording on specified forms.
• Builds comprehensive knowledge base, and continuously works toward remaining knowledgeable and current of Medicare / Insurance information and regulations, RHCD products and services and community resources.
• Performs intake, insurance verifications, preauthorization's (when required), and processing of all referrals for services lines within the Home Care Division.

Qualifications

Education

Experience

Licenses and Certifications

To learn more about being a team member with Riverside Health System visit us at https : / / www.riversideonline.com / careers .