At Home Advisor

Overview

Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change.

At Hackensack Meridian Health at Home, we recognize our full- and part-time benefit eligible team members by offering a Total Rewards package including comprehensive Health Benefits, generous Paid Time Off, Travel Reimbursement as well as an investment in your future with a 401(k) match and Tuition Reimbursement. Per Diem team members are eligible to participate in Travel Reimbursement and may be eligible to receieve a 401(k0 match. At www.TeamHMH.com,  you’ll find the information, resources and tools that will help you to be successful at HMH. From great benefits and innovative wellness programs, to robust learning and development opportunities, we continue to cultivate an exceptional work environment where you can do the kind of work that leads to fulfillment and professional growth.

Qualifications

Education, Knowledge, Skills and Abilities Required:

• High School diploma, general equivalency diploma (GED), and/or GED equivalent programs. Associates Degree preferred
•  Proficient in Microsoft Office Suite
• Strong Customer Service Skills

Education, Knowledge, Skills and Abilities Preferred:

• Home Care Experience
• One (1) to Two (2) Years Healthcare Experience
• Billing/Insurance Authorization Experience

Responsibilities

Responsible for processing assigned Central Intake referrals.  Responsible for procuring all incoming referrals and obtaining necessary documentation to support clean billing.  Demonstrate optimum customer service skills.  Perform authorization and verifications for identified product lines.  Enter the required information into appropriate system accurately and assure clean claims for timely reimbursement.

• Answer incoming telephone calls.  Monitor all referral management systems for new and referral updates on a continuous basis.  Answer calls and questions utilizing excelling customer service skills.  Assist with outside referrals if organization is unable to accommodate referral request.  Network and build relationships with facility staff.
• Provide information to referral sources regarding programs and services available to meet customer¿s needs.  Answer all questions correctly and utilize intake resources when needed to assure information is correct.
• Screen calls for appropriateness.  Demonstrate a clear understanding of the client¿s needs and priorities.  Transfer calls to RN for orders.  Enter accurate referrals from any At Home product line.  Identify opportunities for cross selling and utilize them to assist patients by providing other services necessary to meet their needs.
• Demonstrate adherence to intake process for each referral from start to hand off to operations for scheduling.  Meet productivity standards on a daily basis.  Maintain an accurate account file following all intake processes.  Drill down to root referral source to obtain primary referral information.  Enter all information correctly and in detail for each patient.  Obtain necessary documentation adhering to intake process.  Obtain face-to-face (F2F) information and hand off to F2F team with appropriate information.
• Knowledgeable in current Medicare reimbursement criteria and insurance contracts for the organization product lines.  Network with insurance payor case managers to assure ease of referrals for home care services utilizing customer service skills.  Obtain all necessary documents on a consistent basis.  Assure insurance verification and authorization is appropriate to assure clean billing and prompt payment.
• Verify member eligibility and ensure correct billing information.  Contact benefit provider to gather policy benefits/limitations and ensure service provided will be reimbursed.  Utilize shared drive for insurance contracts.  Contact insurance companies to verify coverage and obtain authorization in a timely manner.  Document all communications into appropriate software systems in a timely manner.
• Obtain and communicate all insurance needs assigned by supervisor to the appropriate operation.  May also communicate with billing agencies for all changes, modifications or additions for client.  Follow up with omitted communications or documents as assigned.
• Assure communication is timely and appropriate with all organization operations.  Utilize tracking system to follow up on pending cases.  Organize information, services resources and contracts.  Problem solve with staff on any pertinent patient referral issues.  Take ownership to assure that delivery of services meet customer and referral source expectations.
• Other duties and/or projects as assigned.  Respond to needs of department by performing duties/tasks assigned to assure departmental functions are performed when staffing challenges are encountered and when team members need assistance as assigned by manager.
• Adheres to HMHs Organizational competencies and standards of behavior.
• Lifts a minimum of 10 lbs., pushes and pulls a minimum of 10 lbs. and stands a minimum of 2 hours a day.