Patient Access Clinical Coordinator

Valley Health Systems•Holyoke, MA

About The Position

The Holyoke Visiting Nurses Association, Inc. is hiring a Patient Access Coordinator for a full-time agency position. The role requires critical thinking, independent decision-making, and the ability to work in a fast-paced environment with little to no direct supervision. Strong customer service skills are essential when working with patients, clinicians, providers, and referral sources. The coordinator obtains and evaluates referrals for home health and hospice services, discusses available services with referral sources, assesses patient needs and payer eligibility based on referral information, and follows up to complete missing or incomplete documentation. The role enters referral and order information into Clinical Link, the EMR, and other computer systems; coordinates initial home assessments with Clinical Operations; and communicates patient needs and order changes to appropriate staff. The coordinator also responds to and triages calls from patients, physicians, facilities, and field clinicians. This may include clinical phone intervention, arranging a skilled home visit, obtaining or clarifying orders, and advising clinicians. The position establishes and maintains positive relationships with internal and external customers and performs other similar duties as assigned.

Requirements

Knowledge of public health nursing and hospice nursing.
Current Massachusetts licensure as a Registered Nurse (RN) or Licensed Practical Nurse (LPN).
At least three years of nursing experience.
At least one year of experience in home care and/or hospice.
Ability to think critically and make independent decisions.
Ability to work in a fast-paced setting with little to no direct supervision.
Strong customer service skills.

Responsibilities

Obtain referrals for services, including patient information, diagnosis, and physician orders with details for direct care.
For hospice referrals, obtain terminal diagnosis and pertinent medical history, evaluate hospice eligibility, and submit an order for a comfort care pack when needed.
Discuss home health and hospice services with referral sources, answer questions, and identify services available for referred patients.
Assess initial patient needs for home care and hospice services based on referral information and determine whether Medicare, Medicaid, or other third-party payer criteria are met.
Evaluate referral information for completeness and signatures, and follow up with referral sources for missing or incomplete information.
Enter patient referrals, interoffice referrals, cancellations, and other information into Clinical Link and other computer systems.
Offer alternative care settings when home care is not appropriate, such as outpatient mental health providers or skilled nursing facilities.
Coordinate with Clinical Operations to assign initial home assessments and advise on level of need and appropriate assessing clinician.
Communicate patient needs to supervisors, referral centers, clinical staff, and other appropriate individuals.
Answer and triage VNA patient calls, including providing clinical phone intervention, assigning skilled home visits, and coordinating with field clinicians when needed.
Consult with Clinical Operations as needed to assign a PRN skilled home visit.
Answer physician and facility calls to obtain orders or provide directions on VNA care.
Answer field clinician calls and provide advice and support as needed.
Process VNA interim orders received by fax, phone, or email and enter them into the EMR as needed.
Promptly alert Clinical Operations and appropriate field clinicians to changes in orders.
Evaluate orders for completeness and request additional orders or discipline orders when a skilled need is apparent.
Perform other similar or related duties as responsibilities necessitate or as assigned.
Establish and maintain positive relationships with internal and external customers.