Position Summary

The primary purpose of your job position is to coordinate and maintain ongoing tracking and appropriate documentation on referrals and all admissions for Hospice and Palliative. Received and documents patient referrals, follows referral process to determine admission criteria. With patient/family, Medical Director and Admission Team, Referral Management initiates admission process through timely and professional communication and has a thorough understanding of Hospice Medicare/Medicaid Conditions of Participation and program capabilities and limitations.

Duties and Responsibilities

· Ensure complete and accurate registration, including patient demographic and current insurance information & assist Community Liaison to obtain.

· Assemble information concerning patient’s clinical background and referral needs. Per referral guidelines, provide appropriate clinical information to specialist & Physician order.

· Present necessary medical information such as history, diagnosis and prognosis. Provide specific medical information to financial services to maximize reimbursement to the company.

· Review details and expectations about the referral with patients as needed.

· Assist patients in problem solving potential issues related to the health care system, financial or social barriers (e.g., request interpreters as appropriate transportation services or prescription assistance).

· Panda Doc

· Optima

· Pre-Authorizations / VA

· Coordinate admission nurse assignment with Area Manager (Lead Nurse)

· Conduct educational visits/calls whenever needed

· Be the system navigator and point of contact for patients and families, with patients and families having direct access for asking questions and raising concerns. May assume advocate role on the patient’s behalf with the carriers to ensure approval of the necessary supplies/services for the patient in a timely fashion.

· Ensure that referrals are addressed in a timely manner to include after hours and weekends as needed

· Narrative write up for nurses

· Face to Face line up and documentation

· Maintain referral log & area census spreadsheet

· Coordinate Palliative/ Physician Services referrals

· Request Medical records and ensure all paperwork completed to include insurance information

· Forward referral information to appropriate Palliative staff member

· Additional duties may be assigned as needed.

Requirements:

• Must have at minimum an LPN license
• Must have 3-5 years experience
• Must have hospice or hospital experience