Come grow with us!  Our company has been voted one of the fastest growing companies this year and 92% of our employees feel we are the Best Place to Work! Our team is growing, and we have an excellent administrative opportunity for a nurse or clinical social worker who is ready to grow and is experienced in managing referrals, ensuring appropriate care and collaborating across multiple physician and administrative teams and patience in home health setting. This role ensures smooth transitions from hospitals or skilled nursing facilities (SNF) to home care services and will report to the companies Vice President of Clinical Innovations.

This is a full-time on-site position in New Orleans, Louisiana, offering $80,000 salary plus annual performance bonus, benefits inclusive of immediate health/dental/vision coverages, 15 accrued days of vacation, 7 paid holidays, 5 sick days, 401k Plan with company match and more. 

​​​​​​Essential Duties and Responsibilities:  Below are typical responsibilities and not an exhaustive list of all duties. Other duties may be assigned as needed:

1. The screening and accurate completion of referrals to ensure patients meet agency admission criteria and comply with state and federal regulations.

• Processes referrals for all programs (Traditional, Peds, and Infusion Therapy) from hospital sites, MD offices, utilizing standard work and determines whether patient qualifies for home care based on established guidelines.
• Verify home health care benefits according to payor plans. Obtains authorizations for services as indicated.
• Ensures physicians initial home care orders are obtained.
• Identifies risk management situations and completes high risk referral process on all appropriate patients based on established guidelines.
• Interprets company services, admission criteria and medical policies to referral sources and individuals seeking information.
• Documents the initial plan of home health care and initiates interdisciplinary communication.
• Interviews patients/families in the hospital or SNF, to assess and evaluate patient for home care appropriateness.
• Works in conjunction with the care management staff to assist the patient/family in the initiation of home care services. Responds to inquiries regarding home care services.
• Works within established productivity guidelines for assigned site(s). Reports productivity to supervisor daily.
• Trains patients/families in using equipment (e.g. pump) at home.

2. Provide quality customer service; promote collaboration/coordination between referral sources and home care services to promote continuity of care and utilization of home care resources effectively.

• Acts as a resource to physicians, physician offices, patients and families, hospital and designated skilled nursing facility staff (i.e. care management, discharge planners, social workers, nursing) regarding types of services available and the criteria for home care, including Medicare guidelines.
• Provides education to the care team as requested on services that may enhance the transition of care for patients including DME, Hospice, Palliative Care, Pediatrics and Home Infusion Therapy.
• Maintains knowledge of Medicare, Medicaid and HMO procedures.
• Attends site based multidisciplinary meetings (e.g. readmissions, capture, discharge planning) that involve Advocate at Home patients.
• Assures appropriate follow-up to patient satisfaction issues relating to home care services.
• Provides courteous service to patients, families, staff, and physicians.
• Accountable for ensuring complete referral information is obtained for accurate and timely billing.
• Maintains knowledge of agency payers including Medicare, Medicaid and contracted commercial insurance reimbursement guidelines.
• Collaborates with insurance verification to insure optimal reimbursement.
• Assists in the development of policies and procedures to ensure compliance with current practice standards.
• Obtains Face-to-Face (F2F) encounter form for all Medicare, Medicaid and Medicaid pending patients during referral process or within the first 7 days.
• Educates physicians in the Face-to-Face process.

3. Teamwork and Collaboration:

• Maintains competency by attending monthly training and interdisciplinary team meetings.
• Provides suggestions or improvements in current practices (i.e. process, documentation, etc.) to improve quality, productivity and customer satisfaction.
• Provides a positive attitude for Advocate at home through self-management.
• Provides input regarding performance and compliance to standards of peers.
• Adapts to changing business needs, conditions and work responsibilities.
• Partners with peers to ensure productivity levels are achieved.
• Follows standard operating procedures and guidelines during referral processing to ensure consistent messaging and superior customer service is provided.
• Participates in precepting new hire training and orientation.
• Partners with peers and other product lines to provide complete and thorough patient hand-offs when appropriate.

Job Requirements (skills, abilities, proficiency):

• Valid and unrestricted license for either LPN, RN, PT, OT, SLP or CSW.
• At least 3 years of experience in home health setting with processing referrals from hospitals and physician offices and obtaining authorizations for medical services.
• At least 3 years of experience with Medicare, Medicaid and commercial insurance reimbursement guidelines and other payers, and proficiency with billing codes.
• At least 3 years of experience using EMR, EHR systems and strong experience with other IS utilizing in medical practices.
• Experience and excellent customer service and communication skills with patients, patient families, physicians, and medical facilities.
• Bachelor’s degree in health administration, business or relevant fields.

Physical Requirements (lifting, sitting, standing, climbing, workspace requirements, if any):

• Ability to drive between two hospital locations in New Orleans, Louisiana (70121)
• Ability to use keyboard and computer for extended periods of time.
• Ability to sit and/or stand for extended periods of time.
• Ability to lift up to 20 lbs.

EOE/M/F/Vet/Disability: