WI Referral Processing Specialist

American Addiction Centers • Milwaukee, WI

1d • Remote

About The Position

This full-time position is responsible for collecting and recording medical, social, and reimbursement data pertinent to patient admission to initiate home care, palliative care, and hospice services. The role involves screening, documenting, and processing requests for these services, including taking incoming calls, answering customer questions, completing intake forms, processing referral orders within EPIC or via fax, and documenting service requests for care coordination. The specialist will also promote company products and services, collaborate with the nursing team on physician orders, communicate updated information to relevant parties, and respond to inquiries about Aurora at Home services and programs. A key aspect of the role is explaining programs, determining if patients meet criteria for a CMS-certified agency, and referring requests to other community agencies when appropriate. Maintaining knowledge of Medicare, Medicaid, and third-party payer requirements, coverage, guidelines, and documentation is essential.

Requirements

• High School Graduate.
• Typically requires 1 year of experience in a clinical environment.
• Basic medical knowledge.
• Strong verbal and written communication skills a must including experience in data entry, multi-line phone system, and customer service experience.
• Excellent interpersonal skills necessary to interact with internal and external customers.
• Demonstrated ability to work well with physicians and other professionals.
• Proficient computer skills including word processing and electronic mail.
• Must be detail-oriented and have excellent organizational skills.
• Must have working high speed home internet.
• Must be accessible and able to connect via ethernet cable 100-300Mbps suggested.

Responsibilities

• Collects and records medical, social and reimbursement data pertinent to patient admission to initiate home care, palliative care and hospice.
• Screens, documents and processes requests for home health, palliative and hospice services.
• Takes incoming calls, answers customer questions, completes intake forms, processes referral orders within EPIC or faxed referrals and documents service requests for coordination of care.
• Promotes company products and services.
• Collaborates with the nursing team when reviewing and processing physician orders for instructions on patient's plan of care and prior to sending patients to the appropriate patient service department to ensure activities are performed within the scope of practice.
• Communicates and documents any new, changed, updated information, orders or referrals received within intake to the appropriate persons and/or departments as needed to not compromise the quality of care and safety of patient(s).
• Responds to inquiries regarding Aurora at Home services and programs.
• Explains programs and services, in addition to determining if patients meet criteria for Centers for Medicare & Medicaid Services (CMS) certified agency, admission policies and/or referring requests to other community agencies when appropriate.
• Maintains knowledge of and reference materials of Medicare, Medicaid and third-party payer requirements, payer coverage, guidelines, documentation requirements and insurance related changes or trends.

Benefits

• Competitive compensation
• Generous retirement offerings
• Programs that invest in your career development
• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 1-10 employees