What are the responsibilities and job description for the Home Care Liaison Representative position at Blessed Oasis Homecare LLC?
Home Care Liaison Representative
Job Overview:
The Home Care Liaison Rep serves as a vital connection between home care services, clients, healthcare providers, and community organizations. This role involves coordinating care, ensuring compliance with Medicaid and waiver programs, managing relationships with Managed Care Organizations (MCOs), and overseeing billing processes. The ideal candidate will have experience with Medicaid, waiver services, MCOs, and home care billing procedures.
Key Responsibilities:
Client Assessment & Onboarding:
- Conduct initial consultations to evaluate client needs and determine eligibility for Medicaid and waiver services.
- Explain available home care services and assist clients in navigating Medicaid and waiver program requirements.
- Ensure timely and accurate completion of intake and enrollment documentation.
Care Coordination & Support:
- Collaborate with caregivers, nurses, and healthcare professionals to match clients with appropriate services.
- Monitor ongoing care and make necessary adjustments to service plans.
- Serve as a point of contact for clients and families regarding service updates and concerns.
Medicaid, Waiver Services & MCO Coordination:
- Work directly with Medicaid, waiver programs, and MCO representatives to ensure compliance and proper service authorization.
- Submit and track authorization requests for home care services.
- Stay up to date with changes in Medicaid policies, waiver programs, and MCO requirements.
- Advocate for clients by addressing discrepancies and resolving authorization or coverage issues.
Billing & Reimbursement Management:
- Oversee and manage billing processes for Medicaid, waiver services, and MCO reimbursements.
- Ensure timely and accurate claims submissions and follow up on denials or payment delays.
- Work with the finance team to reconcile payments, verify service documentation, and resolve billing issues.
- Maintain compliance with Medicaid and MCO billing regulations to minimize claim rejections.
Relationship Management:
- Build and maintain strong relationships with hospitals, nursing homes, community agencies, Medicaid representatives, and MCO contacts.
- Serve as a liaison between home care agency and external partners to streamline referrals and service approvals.
- Educate clients, families, and healthcare providers on available home care options and funding sources.
Compliance & Documentation:
- Ensure all services adhere to state and federal Medicaid regulations, waiver program policies, and MCO guidelines.
- Maintain comprehensive client records, including assessments, authorizations, and billing documentation.
- Assist in audits, compliance reviews, and quality assurance initiatives.
Community Outreach & Marketing:
- Promote home care services to potential clients and referral partners.
- Participate in community events, workshops, and networking opportunities to raise awareness.
- Develop strategies to increase Medicaid and waiver service enrollments.
Crisis Management & Problem-Solving:
- Address urgent client and caregiver concerns efficiently and compassionately.
- Troubleshoot service interruptions, billing disputes, and authorization delays.
- Implement process improvements based on client and provider feedback.
Required Skills & Qualifications:
- Experience with Medicaid, waiver services, MCOs, and home care billing.
- Background in healthcare administration, social work, case management, or medical billing (preferred).
- Strong knowledge of Medicaid billing codes, claims processing, and reimbursement policies.
- Proficiency in billing software, Electronic Visit Verification (EVV) systems, and medical claims processing platforms.
- Excellent interpersonal, communication, and problem-solving skills.
- Ability to multitask, work independently, and navigate complex healthcare systems.
- Familiarity with HIPAA, home care regulations, and patient confidentiality policies.