Newport News, Virginia

Hiring Range

$18.20 - $23.68/Hourly Actual pay is determined based on job-related factors such as relevant experience, education, credentials, skills, internal equity, and business needs.
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 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. Assists team to complete the workload for the department daily.

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 another 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

• High School Diploma or GED, (Required)

Experience

• 2 years Healthcare (Required)
• 1 year Homecare (Preferred)

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