This is professional work providing technical support for applicants/clients with brain and spinal cord injuries. Applicant/Client Services: Responsible for all aspects of coordinating, issuing and processing authorizations for consumer client care as outlined in the Brain and Spinal Cord Injury Program Policies and Procedures. Track / coordinate all outpatient therapy (progress notes, UBs/EOBs, PAFs). Monitor budget periodically to avoid encumbering authorization in red. Scan authorizations for signature to CMs who are telecommuting before faxing to vendor and prior to approval. Obtains vendor quotes for consumer client services in accordance with Departmental purchasing. guidelines by Compose and Submit Faxes to vendors/facilities, etc. Generate monthly reports to monitor outstanding authorizations. Performs all necessary actions to process authorizations for payment in accordance with Department and Brain and Spinal Cord Injury Policies and Procedures. Monitor Outpatient therapies and bills. Process Refund / Warrant Checks in Rims-input information, scan documents (Case Receipt Transmittal Form, Check, Authorization) email to Kimberly, Sandra Horne and mail to F/A. Client contact documentation: Contacting client in accordance with BSCIP Policy and Procedures to gauge client progress and need for services. Also, availability to provide support and answer questions from client and family about services. Correspondence/Documentation Activities: Responsible for maintaining all required correspondence/documentation activities as outlined in the Brain and Spinal Cord Injury Program Policies and Procedures. ITI Follow up – Consent Form sign, Contact Letters, Scan Documents, Periodically monitoring for a year. Mails correspondence to referrals/applicants/clients and providers as required or requested. Responsible for entering any pertinent case note data regarding activities performed by the incumbent in this position in the Rehabilitation Information Management System (RIMS) for applicant/client records documenting referral/client, family, provider or other contacts; or any activities conducted for or relating to the client. Pull FMMIS reports regularly, scan and document in RIMS. Maintain client’s current contact information in RIMS (physical location/phone/change of address etc.) Scans referral/client-related documentation into RIMS client records. Review all incoming faxes to Regional office to retrieve whatever is applicable, and scan under a case note in RIMS within 48 hours of receipt. Apprise CMs by TTD for review. Upload confirmation of out-going faxes in RIMS with cover sheet and attachment. Request MESF (Medical Eligibility Screening Forms) and medical records to include discharge summary, with updates as needed, until medical stability. Provide Case Synopsis Sheet and obtain quotes for DME (durable medical equipment) and/or consumable medical supplies etc. and check on delivery date before discharge. Prepare Disclosure Log as applicable and scan in RIMS. Contact billing personnel for monthly invoices (UB04s) and EOBs (Explanation of Benefits) in accordance with pre-authorizations scanned in RIMS by CMs. Obtain reports for all out-patient therapies as authorized by BSCIP or checked as having other insurance on the Community Reintegration Plan. Metro Transportation Passes-Order thru email, pick up at Metro Dade, scan letter, case notes Metro pass in RIMS, mail to clients. Other Duties as Assigned include the following: Process outgoing mail to include affixing return address labels. Prepare self-addressed stamped envelopes for application packets requiring signature. Enter details and scan Certified Mail Receipts for closure letters in RIMS. Use scale for weight calculation and enter required details on postage log. Verify address on USPS (United States Postal Service) website and enter after checking FMMIS eligibility in RIMS case note titled Verification of Benefits. This is done for all pediatric and SCI referrals upon assignment, besides cases received as transfer from BIAF. Details are cross checked with Face Sheet requested from hospital staff. Distribute all incoming mail such as facility invoices and reports after looking up CM assignments in RIMS. Prepare UPS (United Parcel Service) shipping labels for packages as requested and track delivery. Copy records in response to client or attorney requests and scan accordingly or mail to recipient as advised by CM. Read and respond to e-mails or calls from hospital trauma staff regarding whether already reported to Central Registry after looking up RIMS. Complete webinars or training modules to meet given deadlines and participate in staff meetings or teleconferences. Review TTDs in RIMS to acknowledge in timely manner or process for completion. Answer inquiries from providers and out-patient facilities regarding payments, and train new staff on reconciliation of checks in Florida Comptroller’s Vendor Information portal. Obtain e-mails of staff in billing and records management, and relay requests for addition to Move It, to minimize error messages on fax.
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Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
1,001-5,000 employees