Full employer posting
Newport News, Virginia Hiring Range $57,100.00 - $78,550.00/Annual Actual pay is determined based on job-related factors such as relevant experience, education, credentials, skills, internal equity, and business needs. Overview Works under the supervision of the Homecare Sales & Business Development Director. This position is responsible for oversight of the referral intake process for the service lines within the Riverside Home Care Division.
Accountable for insurance verification, initial pre-authorization and timely coordination of the referral process. Supervises Central Intake staff and manages the daily activity of the department. Remains current with Medicare/insurance reimbursement issues and regulations to include coverage criteria.
Manages and oversees the referral intake process for the Home Care Division. Accountable for insurance verification, initial pre-authorization and coordination of the referral process. Stays cognizant of Medicare/Medicaid and Commercial insurance changes and other reimbursement issues, and assures billing process is accomplished timely and accurately.
Coaches, mentors, and develops staff competencies. Provides ongoing and constructive feedback, orientation, education, performance evaluation and if necessary, disciplinary actions for all employees (and contracted staff if applicable) under their supervision. Keeps staff up to date on current and changing billing and/or reimbursement information and practices.
Holds monthly staff meetings to keep staff informed. Maintains a competent engaged, motivated work force. Provides ongoing and constructive feedback, orientation, education, performance evaluation and if necessary, disciplinary actions for all employees under supervision.
Turnover rates are within target and BPA results for Front Line Manager Index show positive trend. Keeps staff abreast of developments, progress and activities through regular meetings and communication Ensures referrals are done in an accurate and timely manner based on established criteria to include referral intake, insurance verification, and initial authorization for services. Reviews and evaluates referrals for eligibility for services.
Works with Patient Transition Coordinators at hospitals in identifying and evaluating clients who may be appropriate for Home Care services. Reviews and revises policies and procedures with needed updates on an annual basis at minimum. Remains knowledgeable of Medicare/insurance reimbursement-related issues and regulations as well as coverage criteria for all payor sources.
Qualifications Education Associates Degree, Practical Nursing (Required) or Bachelors Degree, Business (Required) Experience 2 years Home Health (Required) 1 year Insurance Verification/Authorization (Required) Licenses and Certifications Licensed Practical Nurse (LPN) - Virginia Department of Health Professions (VDHP) Upon Hire(Preferred) To learn more about being a team member with Riverside Health System visit us at https://www.riversideonline.com/careers .
About the role
Works under the supervision of the Homecare Sales & Business Development Director. This position is responsible for oversight of the referral intake process for the service lines within the Riverside Home Care Division. Accountable for insurance verification, initial pre-authorization and timely coordination of the referral process.