Core Competencies

• Accepts referrals from hospitals, physician offices, SNFs and other community referral sources, obtains required orders for services and coordinates infusion products and DME/HME delivery
  
  
• Pre-screens clients referred by physicians for hospice needs, eligibility, and homebound status, if appropriate
  
  
• Evaluates patients referred to the Organization; identifies insurance coverage, negotiates payment or per diem rates; plans and coordinates referrals for hospice services.
  
  
• Collaborates with the case manager to expedite discharges and screen admission requests..
  
  
• Triages the needs of referred patients to assist scheduling for same day or within 48 hours of referral
  
  
• Elevates issues as appropriate to the Director, Revenue Cycle.
  
  
• Responds to voicemail and emails within 24 hours of receipt. Forwards patient complaints to the Lead Patient Account Representative or Director, Revenue Cycle, when appropriate.
  
  
• Stays informed of updated insurance requirements and reimbursement practices
  
  
• Maintains an advanced knowledge of insurance payor contracting as well as authorization requirements by payor.

• Maintains knowledge of the methods of payment, pricing and insurance billing.
  
  
• Maintains comprehensive working knowledge of managed care contractual relationships and ensures that patients are admitted and services are delivered in accordance with contract provisions.
  
  
• Develops and maintains cooperative relationships with hospital personnel, physicians, suppliers and insurance case managers.

• Arranges for alternate hospice providers utilizing Letter of Agreement for capitated patients out of the service area.

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  Sets realistic expectations with patients/families regarding hospice service
    

    

    

Education

Experience

Compensation Range  

$46.88 - $77.97 / Hour