Business Office Rep-HH

Prisma Health•Greenville, SC

3d•Onsite

About The Position

Performs a variety of duties to support and facilitate the maintenance of accurate and efficient business operations. Provides direct customer service and/or clerical/administrative support for the department. Handles all incoming calls to the Agency with efficiency, professionalism and adherence to HIPAA and other applicable regulations. Provides information to callers/visitors pertaining to the services of Home Health and Hospice. Confirms with newly referred patients their understanding of Home Health services and their willingness to receive services. Answers multi-line telephone and gives information to callers or routes calls to appropriate staff; greets internal/external callers/visitors in a prompt, pleasant and professional manner. In the absence of an intake coordinator, may be responsible for the Referral and Intake process within the agency. Initiates patient record and files incoming documents; reviews referral information in EPIC supplied from referral source. Performs data entry and input of medical information and maintains patient records and data to support the billing, scheduling, payroll, and compliance functions for the agency. Responsible for maintenance and location of records, including coordination of medical record storage for discharged files. Responds promptly to telephone, electronic, and written requests for medical records. Faxes/Processes physician orders and tracks for timely return. Maintains relationships with physicians, physician staff, and hospital staff in regard to unsigned orders to ensure return within regulatory guidelines. Prepares supply requisitions through on-line order system to meet Home Health/Hospice medical supply stock requirements. Supports clinical supply needs for home visits. Routinely performs price comparisons and product alternatives for Agency. Responsible for maintaining supply closet with routine supplies, ensuring supplies are within expiration dates and packaged appropriately, and serves as a liaison with the field for patient supply needs. Maintains a thorough working knowledge of scheduling procedures and communicates effectively with clients and staff. Maintains the ongoing scheduling of patient visits for all assigned field staff, as well as communication updates, changes, and new admissions to ensure continuity and coordination of patient care services. Works collaboratively with field clinicians to ensure all patient visits are scheduled and completed as ordered. Manages calls from patients and field clinicians related to scheduling issues. Refers clinical and performance related issues to the Nurse Manager. Monitors hospitalized patients, communicating and ensuring the team follows up. Responsible for verifying patient eligibility and benefits as well as obtaining authorization for homecare services. Verifies patients Medicaid, private insurance, and self-pay payor sources. Obtains authorization and re-authorization from private insurance and all other payor sources requiring authorization via telephone, fax, or online systems while maintaining compliance to medical record confidentiality. Responds to calls, emails, and other inquiries regarding the status of outstanding referrals and/or authorizations information. Communicates efficiently, effectively, and timely to resolve issues pertaining to the verification and authorization processes. Provides effective program coordination by coordinating and integrating bereavement and administrative services within the department, with other departments, offices and with the hospital’s primary functions. Manages information by providing information systems and data management for department operations and performance improvement. Advanced ability in the use of computer software, correspondence skills, report writing and telecommunications. Maintains programs relative to bereavement functions in compliance with regulatory and licensure requirements. Provides orientation, in-service training and education of bereavement program to designated internal and external customers. Continuously assesses and improves the department’s performance by designing operational processes, monitoring performance through data, analyzing the data, implementing sustainable performance improvement and participating in multi-disciplinary interdepartmental PI activities. May assist in the training of new employees. Performs general office duties for the department, including, data entry, filing, faxing, copying, mail handling/correspondence, scanning, and printing functions. Collects and records statistical data for the completion of reports regarding staff productivity, patient services, and other Homecare operations. May serve as the timekeeper for agency personnel or other agency productivity tracking personnel. Runs all applicable reports and responds and monitors referral WQs. Assists with internal or external transfer of patients between HH and Hospice services, if applicable. Performs other cross-trained role functions within agency as staffing needs require and as assigned and maintains a clean and safe environment for team members and visitors. Performs other duties as assigned.

Requirements

High School diploma or equivalent
One (1) year healthcare, business, and revenue cycle experience.
Knowledge of office equipment
Proficient computer skills (spreadsheets, data entry)
Mathematical skills

Responsibilities

Handles all incoming calls to the Agency with efficiency, professionalism and adherence to HIPAA and other applicable regulations.
Provides information to callers/visitors pertaining to the services of Home Health and Hospice.
Confirms with newly referred patients their understanding of Home Health services and their willingness to receive services.
Answers multi-line telephone and gives information to callers or routes calls to appropriate staff; greets internal/external callers/visitors in a prompt, pleasant and professional manner.
In the absence of an intake coordinator, may be responsible for the Referral and Intake process within the agency.
Initiates patient record and files incoming documents; reviews referral information in EPIC supplied from referral source.
Performs data entry and input of medical information and maintains patient records and data to support the billing, scheduling, payroll, and compliance functions for the agency.
Responsible for maintenance and location of records, including coordination of medical record storage for discharged files.
Responds promptly to telephone, electronic, and written requests for medical records.
Faxes/Processes physician orders and tracks for timely return.
Maintains relationships with physicians, physician staff, and hospital staff in regard to unsigned orders to ensure return within regulatory guidelines.
Prepares supply requisitions through on-line order system to meet Home Health/Hospice medical supply stock requirements.
Determines if inventory quantities are sufficient to meet department needs and are within expiration guidelines.
Supports clinical supply needs for home visits.
Routinely performs price comparisons and product alternatives for Agency.
Responsible for maintaining supply closet with routine supplies, ensuring supplies are within expiration dates and packaged appropriately, and serves as a liaison with the field for patient supply needs.
Maintains a thorough working knowledge of scheduling procedures and communicates effectively with clients and staff.
Maintains the ongoing scheduling of patient visits for all assigned field staff, as well as communication updates, changes, and new admissions to ensure continuity and coordination of patient care services.
Works collaboratively with field clinicians to ensure all patient visits are scheduled and completed as ordered.
Manages calls from patients and field clinicians related to scheduling issues.
Refers clinical and performance related issues to the Nurse Manager.
Monitors hospitalized patients, communicating and ensuring the team follows up.
Responsible for verifying patient eligibility and benefits as well as obtaining authorization for homecare services.
Verifies patients Medicaid, private insurance, and self-pay payor sources.
Obtains authorization and re-authorization from private insurance and all other payor sources requiring authorization via telephone, fax, or online systems while maintaining compliance to medical record confidentiality.
Responds to calls, emails, and other inquiries regarding the status of outstanding referrals and/or authorizations information.
Communicates efficiently, effectively, and timely to resolve issues pertaining to the verification and authorization processes.
Provides effective program coordination by coordinating and integrating bereavement and administrative services within the department, with other departments, offices and with the hospital’s primary functions.
Manages information by providing information systems and data management for department operations and performance improvement.
Maintains programs relative to bereavement functions in compliance with regulatory and licensure requirements.
Provides orientation, in-service training and education of bereavement program to designated internal and external customers.
Continuously assesses and improves the department’s performance by designing operational processes, monitoring performance through data, analyzing the data, implementing sustainable performance improvement and participating in multi-disciplinary interdepartmental PI activities.
May assist in the training of new employees.
Performs general office duties for the department, including, data entry, filing, faxing, copying, mail handling/correspondence, scanning, and printing functions.
Collects and records statistical data for the completion of reports regarding staff productivity, patient services, and other Homecare operations.
May serve as the timekeeper for agency personnel or other agency productivity tracking personnel.
Runs all applicable reports and responds and monitors referral WQs.
Assists with internal or external transfer of patients between HH and Hospice services, if applicable.
Performs other cross-trained role functions within agency as staffing needs require and as assigned and maintains a clean and safe environment for team members and visitors.
Performs other duties as assigned.