Department: Clinical
Reports To: Senior Director of Operations

Mission

The Natick Walpole VNA is committed to a traditional, yet innovative approach of providing highly skilled compassionate home health care to the communities it serves. The Agency continually strives to be responsive to patient and community needs, to promote healthy lifestyles, and facilitate independence and resourcefulness to enable people to remain in their own homes, thereby enhancing their quality of life.

Job Summary

Responsible for the thorough receipt of patient information from referral sources and communication of this information to the clinical leadership and direct patient care staff.  Responsible for assisting with the procurement of authorizations for care and providing clinical information for claim appeals.  Works with the Marketing Liaisons and clinical managers in supporting the smooth flow of referrals.

Responsibilities:

  • Review and assess incoming referrals to determine clinical appropriateness for admission.
  • Facilitate timely procurement of required referral components including authorization, physician orders and discharge paperwork.
  • Interface with physician offices and discharge planners to assess and process referrals and admissions for homecare service.
  • Collaborate with the clinical manager to ensure appropriateness for home care and adequate staffing needs.
  • Provide consultation and assistance to the commercial billing staff on appeals and provide medical back-up documentation needed for claims.
  • Act as community resource to referral sources inquiring about community-based care options.
  • Gather pertinent details during referral process including complete diagnosis and medication lists, emergency contact information, primary care physician and consulting physician data.
  • Assist the Intake team with all components of the referral intake process including clinical coordination, record creation, and physician order follow-up.
  • Additional duties to support the needs of the organization.

Preferred Qualifications:

  • RN with a current state license
  • Experience in home health care
  • Strong clinical knowledge
  • Excellent communication and customer service skills
  • Positive teamwork mentality
  • Working knowledge of electronic health records systems, a plus
  • Knowledge of home care reimbursement a plus
  • Ability to multitask and great organizational skills.

 

Work Environment:

  • Must demonstrate ability to work in a team-oriented environment.

 

Physical Requirements:

Must be able to:

Lift up to 20lbs

Push/pull up to 50lbs

Ability to utilize technology applicable to position, including desktop computers and phones